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Intra-aortic balloon pump is associated with the lowest whereas Impella with the highest inpatient mortality and complications regardless of severity or hospital types

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Abstract

Impella and intra-aortic balloon pumps (IABP) are commonly utilized in patients with cardiogenic shock. However, the effect on mortality remains controversial. The goal of this study was to evaluate the effect of Impella and IABP on mortality in patients with cardiogenic shock the large Nationwide Inpatient Sample (NIS) database was utilized to study any association between the use of IABP or Impella on outcome. ICD-10 codes for Impella, IABP, and cardiogenic shock for available years 2016–2020 were utilized. A total of 844,020 patients had a diagnosis of cardiogenic shock. A total of 101,870 patients were treated with IABP and 39645 with an Impella. Total inpatient mortality without any device was 34.2% vs only 25.1% with IABP use (OR = 0.65, CI 0.62–0.67) but was highest at 40.7% with Impella utilization (OR = 1.32, CI 1.26–1.39). After adjusting for 47 variables, Impella utilization remained associated with the highest mortality (OR: 1.33, CI 1.25–1.41, p < 0.001), whereas IABP remained associated with the lowest mortality (OR: 0.69, CI 0.66–0.72, p < 0.001). Separating rural vs teaching hospitals revealed similar findings. In patients with cardiogenic shock, the use of Impella was associated with the highest whereas IABP was associated with the lowest in-hospital mortality regardless of comorbid condition.

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NIS data base is publicly available.

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Authors and Affiliations

  1. University of Arizona Sarver Heart Center, 1501 North Campbell Avenue, Tucson, Arizona, USA

    Mohammad Reza Movahed

  2. University of Arizona, College of Medicine, Phoenix, Arizona, USA

    Mohammad Reza Movahed, Armin Talle & Mehrtash Hashemzadeh

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  1. Mohammad Reza Movahed
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Contributions

All authors had full access to study data and an active role in writing manuscripts. Mohammad Reza Movahed: designing the protocol and the study, writing, and finding ICD codes. Armin Talle: writing the manuscript and conception of method and finding ICD codes. Mehrtash Hashemzadeh: performing statistical analysis, validating data, and writing the manuscript. The authors report no financial relationships or conflicts of interest regarding the content. Herein.

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Correspondence to Mohammad Reza Movahed.

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Movahed, M.R., Talle, A. & Hashemzadeh, M. Intra-aortic balloon pump is associated with the lowest whereas Impella with the highest inpatient mortality and complications regardless of severity or hospital types. Cardiovasc Interv and Ther (2024). https://doi.org/10.1007/s12928-024-00993-8

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