Management of Acute Cardiogenic Shock at the New Brunswick Heart Centre

NCT05414643 | Completed

• 1 other identifier: 101097
• Study Type: observational
• Target: 1,416
• Locations: 1 country
• Sites: 1

Brief Summary

In Atlantic Canada, acute myocardial infarction occurs at a rate of 2.9 % of the population and is the most common cause of cardiogenic shock (CS). In many studies, acute myocardial infarction accounts for up to 80% of the patients with CS. While there are different methods of treating patients with CS, the rate of mortality has not significantly improved over the years and remains as high as 50%. Recent studies have shown that a multi-modal, team-based approach can help improve patient outcomes; however, such a standardized approach is yet to be implemented in the New Brunswick Heart Centre (NBHC). The study aims to understand the difference in outcomes between two groups of patients treated for CS: SHOCK TEAM versus non-SHOCK TEAM. This is a retrospective study of 168 patients using the data from NBHC registry and patient charts. The study duration is 1 year. The primary outcome is hospital survival. Secondary outcomes include time from diagnosis to invasive monitoring and intervention. All data will be analyzed statistically between the two groups. The end goal of the study is to establish standard guidelines to treat CS patients and improve patient survival.

Conditions

Cardiogenic Shock

Keywords

mortality; outcomes; AMI; shock team; SCAI stage; intervention; IABP; ECMO

Outcome Measures

Primary Outcomes (4)

• Percentage mortality

  Any in-hospital mortality (within Saint John Regional Hospital, another hospital after transfer)

  From the date of hospital admission at Saint John Regional Hospital to the date of discharge, assessed upto 6 months

• Length of stay (LOS))

  LOS was considered only for patients who were discharged directly home from Saint John Regional Hospital

  From the date of hospital admission at Saint John Regional Hospital to the date of discharge, assessed upto 6 months

• Discharge disposition

  Discharge of patients home, transfer to another hospital or to another institution (special care home, extra-mural home)

  From the date of hospital admission at Saint John Regional Hospital to the date of discharge, assessed upto 6 months

• Percentage of missed opportunities

  Missed opportunities was defined as patients who suffered significant delays or those who did not receive any intervention

  From the date of hospital admission at Saint John Regional Hospital to the date of discharge, assessed upto 6 months

Secondary Outcomes (1)

• Time from diagnosis of shock to in-hospital processes

  From the date of hospital admission at Saint John Regional Hospital to the date of discharge, assessed upto 6 months

Study Arms (2)

At- risk group (SCAI stages A, B)

Patients who had a SCAI stage A or B at any point during their stay at the New Brunswick Heart Centre, Saint John Regional Hospital. This group was compared with the cardiogenic shock group only for preliminary analysis.

Other: Standard care

Cardiogenic shock group (SCAI stages C-E)

Patients who had a SCAI (Society for Cardiovascular Angiography and Interventions) stage C-E at any point during their stay at the New Brunswick Heart Centre, Saint John Regional Hospital. This group was used for all subsequent analyses.

Other: Standard care

Interventions

Standard care OTHER

No interventions were used, as this is an observational study.

At- risk group (SCAI stages A, B); Cardiogenic shock group (SCAI stages C-E)

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients who were admitted to the CCU at the NBHC, Saint John Regional Hospital between November 1st 2019 to November 30th 2020 were included in the study.

You may qualify if:

• \) Any patient admitted to the CCU with a diagnosis of CS (SCAI groups C, D or E) at any point during their CCU care.

Sponsors & Collaborators

• New Brunswick Heart Centre: lead

Study Sites (1)

New Brunswick Heart Centre

Saint John, New Brunswick, E2L 4L2, Canada

Location

MeSH Terms

Conditions

Shock, Cardiogenic

Interventions

Standard of Care

Condition Hierarchy (Ancestors)

Myocardial Infarction; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis; Shock

Intervention Hierarchy (Ancestors)

Quality Indicators, Health Care; Quality of Health Care; Health Services Administration; Health Care Quality, Access, and Evaluation

Study Officials

• Jean-François Légaré, M.D., Ph.D.

  New Brunswick Heart Centre

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head of Cardiac Surgery

Study Record Dates

• First Submitted: April 14, 2022
• First Posted: June 10, 2022
• Study Start: January 14, 2021
• Primary Completion: October 13, 2021
• Study Completion: October 13, 2021
• Last Updated: June 10, 2022

Record last verified: 2022-06

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)