PGY-3 IM resident University of Houston/HCA kingwood Hospital Houston, Texas, United States
Background: Cardiogenic shock (CS) significantly contributes to mortality in patients with heart failure (HF), yet recent data regarding its mortality trends are lacking. This study aims to shed light on demographic patterns and mortality rates.
Methods: CDC WONDER (1999-2023) data was analyzed to assess CS-related mortality in HF patients aged≥25. Using the Joinpoint regression analysis, we calculated age-adjusted mortality rates (AAMR) per 100,000 patients and average annual percentage changes (AAPC) to analyze the mortality trends.
Outcome: CS accounts for an alarming 108,514 deaths among HF patients. From 1999 to 2023, AAMRs rose from 1.2 to 4.6 (AAPC: 5.90), with the most substantial increases occurring between 2009 and 2021 (APC: 14.17) and again from 2021 to 2023 (APC: 7.83). Disparities are apparent, as men show higher AAMRs than women (2.4 vs. 1.3), with non-Hispanic (NH) Black individuals at greatest risk (AAMR: 2.9), followed by NH whites (AAMR: 1.7). Regionally, West Virginia has the highest AAMR at 2.1, while Wisconsin has the lowest at 0.9. Additionally, rural areas report higher AAMRs than urban ones (1.7 vs. 1.5)
Conclusion: The rising mortality rates from CS in HF patients—especially among men, Black individuals, and those in rural areas require our immediate attention. By implementing targeted interventions and enhancing access to healthcare, we can reduce these disparities and improve patient outcomes.
