Socioeconomic status and equity among patients with cardiogenic shock

Background We aimed to analyze the impact of socioeconomic status (SES) on management and in-hospital outcomes of patients with cardiogenic shock (CS).Methods This was a prospective observational registry conducted (December 2018-November 2019) in Intensive Cardiac Care Units (ICCU) across 8 tertiar...

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Detalles Bibliográficos
Autores: Marcos Mangas, Marta, López Sobrino, Teresa, Ariza Solé, Albert, Rueda Sobella, Ferran, Sanz Girgas, Esther, Aboal, Jaime, Pastor, Pablo, Buera, Irene, Sionis, Alessandro, Andrea Riba, Rut, Rodríguez López, Judit, Tomas, Carlos, Bañeras, Jordi, Llaó, Isaac, Sánchez Salado, Jose Carlos, Garcí García, Cosme, Grup de Treball de Cures Agudes Cardiològiques Societat Catalana de Cardiologia
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/223656
Acceso en línea:https://hdl.handle.net/2445/223656
Access Level:acceso abierto
Palabra clave:Condicions econòmiques
Malalts cardíacs
Infart de miocardi
Economic conditions
Cardiac patients
Myocardial infarction
Descripción
Sumario:Background We aimed to analyze the impact of socioeconomic status (SES) on management and in-hospital outcomes of patients with cardiogenic shock (CS).Methods This was a prospective observational registry conducted (December 2018-November 2019) in Intensive Cardiac Care Units (ICCU) across 8 tertiary care centers. Consecutive patients aged >= 18 years with a primary diagnosis of cardiogenic shock were included. SES was defined using a numerical index that incorporates mean income levels, premature mortality, and avoidable hospitalizations observed within a specific health area. SES values were categorized into tertiles. In-hospital procedures, complications, length of stay, and in-hospital mortality were collected.Results A total of 382 patients were included (mean age: 65.3 years). There were no differences in age, sex, or major comorbidities across SES groups. CS was more frequently due to acute coronary syndrome (ACS) in patients with low SES (66.9% vs. 58%, p = 0.022). No significant differences were observed regarding SCAI stage or other severity markers of CS across SES groups. Patients with low SES were more likely to receive pulmonary artery catheterization (p = 0.029) and mechanical circulatory support (p = 0.038). After adjusting for potential confounders, clinical management was similar regardless SES. Lower SES patients exhibited a higher incidence of bleeding (p = 0.018). There were no differences in length of stay or in-hospital mortality among SES groups.Conclusions Beyond a higher rate of ACS-related CS, patients with low SES exhibited a clinical profile and shock severity comparable to other SES groups. Therapeutic management aligned with guideline recommendations even in patients with low SES.

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