Cardiogenic shock in patients with active onco-hematological malignancies: A multicenter retrospective study

被引：0

作者：

Lescroart, Mickael ^{[1
,2
,3
]}

Kemp, Helene ^{[1
,2
]}

Imauven, Olivier ^{[4
]}

Raphalen, Jean Herle ^{[5
]}

Bagate, Francois ^{[6
]}

Schmidt, Julien ^{[7
]}

Issa, Nahema ^{[8
,9
]}

Decavele, Maxens ^{[10
]}

Moreau, Anne-Sophie ^{[11
]}

Tamion, Fabienne ^{[12
]}

Mourvillier, Bruno ^{[13
]}

Calvet, Laure ^{[14
]}

Canet, Emmanuel ^{[15
]}

Lebert, Christine ^{[16
]}

Pons, Stephanie ^{[17
,18
]}

Lacave, Guillaume ^{[19
]}

Wallet, Florent ^{[20
]}

Winiszewski, Hadrien ^{[21
]}

Merdji, Hamid ^{[22
]}

De Chambrun, Marc Pineton ^{[23
,24
]}

Argaud, Laurent ^{[25
]}

Kimmoun, Antoine ^{[3
,26
]}

Dumas, Guillaume ^{[27
]}

Zafrani, Lara ^{[1
,2
]}

机构：

[1] Hosp St Louis, Paris, France

[2] Univ Paris Cite, Assistance Publ Hop Paris, Paris, France

[3] Univ Lorraine, CHRU Nancy, Med Intens & Reanimat Brabois, Vandoeuvre Les Nancy, France

[4] Grp Hosp Diaconesses Croix St Simon, Inst Anesthesie Est Parisien, Paris, France

[5] Univ Paris 05, Hop Univ Necker Enfants Malad, SAMU, 149 Rue Sevres, F-75015 Paris, France

[6] CHU Henri Mondor, AP HP, Serv Med Intens Reanimat, DHU A TVB, 51 Ave Mal Lattre Tassigny, F-94010 Creteil, France

[7] Grp Hosp Paris Seine St Denis, Avicenne Hosp, Assistance Publ Hop Paris, Unite Med Intens & Reanimat, Bobigny, France

[8] Grp Hosp St Andre, Reanimat Med, 1 Rue Jean Burguet, F-33075 Bordeaux, France

[9] Grp Hosp St Andre, Med Interne & Malad Infect, 1 Rue Jean Burguet, F-33075 Bordeaux, France

[10] Sorbonne Univ, Grp Hosp Univ, APHP, Dept R3S,Serv Med Intens & Reanimat,Site Pitie Sal, F-75013 Paris, France

[11] Hop Salengro, CHU Lille, Serv Med Intens Reanimat, Rue Emile Laine, F-59037 Lille, France

[12] Normandie Univ, Serv Reanimat Med, Dept Digest Physiol, U1096,CHU Rouen, F-76000 Rouen, France

[13] Ctr Hosp Univ CHU Reims, Serv Anat Pathol, Serv Reanimat Med, F-51092 Reims, France

[14] CHU, Hop Gabriel Monpied, Serv Reanimat Med, F-63000 Clermont Ferrand, France

[15] Univ Hosp Ctr, Med Intens Reanimat, Nantes, France

[16] Ctr Hosp La Roche Sur Yon, Serv Chirurg Orthoped, Unite Soins Intens, La Roche Sur Yon, France

[17] Sorbonne Univ, Pitie Salpetriere Hosp, AP HP, Dept Anesthesiol & Crit Care Med,GRC 29,DMU DREAM, Paris, France

[18] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Pulm & Crit Care Med Div, Boston, MA 02115 USA

[19] Ctr Hosp Versailles, Serv Reanimat Med Chirurg, Le Chesnay, France

[20] Hop Lyon Sud, Med Intens & Reanimat, F-69495 Pierre Benite, France

[21] Ctr Hospitalier Univ Besancon, Ctr Hosp Univ Besancon, Med Intens & Reanimat, Besancon, France

[22] Hop Univ Strasbourg, Nouvel Hop Civil, Serv Med Intens & Reanimat, INSERM UMR 1260,Regenerat NanoMed,FMTS, 1 Pl Hop, F-67091 Strasbourg, France

[23] UPMC Univ Paris 06, INSERM UMRS 1166, iCAN Inst Cardiometab & Nutr, INSERM UMRS 1166, Paris, France

[24] Assistance Publ Hopitaux Paris, Sorbonne Univ, Pitie Salpetriere Hosp, Paris, France

[25] Hop Edouard Herriot, Serv Med Intens Reanimat, Serv Anesthesie Reanimat, 5 Pl Arsonval, Lyon, France

[26] MASCOT, INSERM U942, Paris, France

[27] Univ Grenoble Alpes, Serv Med Intens Reanimat, Med Intens Care Unit, CHU Grenoble Alpes,INSERM,U1042 HP2, Grenoble, France

来源：

JOURNAL OF CRITICAL CARE | 2025年 / 87卷

关键词：

Cardiogenic shock; Onco-hematological malignancy; intensive; care; CARDIOVASCULAR TOXICITIES; NOREPINEPHRINE; THROMBOLYSIS; EPINEPHRINE; MANAGEMENT;

D O I：

10.1016/j.jcrc.2025.155028

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose: Onco-hematological (OH) patients face significant cardiovascular risks due to malignancy and drug toxicity. Data are limited on the characteristics and outcomes of OH patients with cardiogenic shock (CS) in intensive care units (ICUs). Methods: This multicenter retrospective study included 214 OH patients with CS across 22 ICUs (2010-2021). The objectives were to (i) identify risk factors for 30-day mortality, (ii) describe early and long-term outcomes, and (iii) assess the prognostic impact of malignancy by comparing OH patients to a control group of CS patients. Results: The 30-day survival rate was 44.8 %. Multivariate analysis identified previous cardiomyopathy (OR = 1.61), acute kidney injury (OR = 1.62), lactate levels (OR = 1.08 per 1 mmol/L), pulmonary embolism (OR = 3.04), invasive mechanical ventilation (OR = 3.48), and epinephrine use (OR = 2.09) as factors associated with 30-day mortality. Among ICU survivors, 54 % were alive at 1 year with a median left ventricular ejection fraction of 52 %. OH malignancy was significantly associated with 30-day mortality (HR 2.54). Conclusion: The prognosis for OH patients with CS in the ICU is poor, with epinephrine use associated with worse outcomes. Further research is needed to refine risk stratification and improve treatments for this population.

引用

页数：9

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