OBJECTIVES: Currently, there are limited data on mortality or predictors of survival for patients admitted to the coronary care unit (CCU). The purpose of this study was to provide data on mortality in the modern-day CCU and to better define factors influencing patient survival. METHODS: A survey was conducted of all patients admitted to CCUs in New York City metropolitan academic hospitals in 2011, followed by a retrospective analysis comparing clinical data from 59 nonsurvivors with those from 897 survivors at two representative institutions. RESULTS: The weighted average mortality in the CCU across all hospitals was 5.6% (range 2.2-9.2%). The average age of the patients admitted to the CCU was 67 years, with 68% being male. Acute coronary syndromes accounted for 57% of all CCU admissions. Survival was worse in patients admitted for cardiac arrest (P=0.000), sepsis (P=0.002), primary respiratory failure (P=0.031), and systolic heart failure (P=0.003). Excluding patients who were made 'do not resuscitate' during their CCU stay, patients receiving treatments such as defibrillation after in-CCU cardiac arrest, right heart invasive monitoring, mechanical ventilation, inotropic support, emergent dialysis, or placement of an intra-aortic balloon pump had higher rates of in-CCU mortality. The most frequent causes of death were intractable cardiogenic shock, brain death, respiratory failure, multiorgan failure, or hypotension. CONCLUSION: This study provides additional mortality information for the modern-day CCU and should help identify factors that may predict survival.
OBJECTIVES: Currently, there are limited data on mortality or predictors of survival for patients admitted to the coronary care unit (CCU). The purpose of this study was to provide data on mortality in the modern-day CCU and to better define factors influencing patient survival. METHODS: A survey was conducted of all patients admitted to CCUs in New York City metropolitan academic hospitals in 2011, followed by a retrospective analysis comparing clinical data from 59 nonsurvivors with those from 897 survivors at two representative institutions. RESULTS: The weighted average mortality in the CCU across all hospitals was 5.6% (range 2.2-9.2%). The average age of the patients admitted to the CCU was 67 years, with 68% being male. Acute coronary syndromes accounted for 57% of all CCU admissions. Survival was worse in patients admitted for cardiac arrest (P=0.000), sepsis (P=0.002), primary respiratory failure (P=0.031), and systolic heart failure (P=0.003). Excluding patients who were made 'do not resuscitate' during their CCU stay, patients receiving treatments such as defibrillation after in-CCU cardiac arrest, right heart invasive monitoring, mechanical ventilation, inotropic support, emergent dialysis, or placement of an intra-aortic balloon pump had higher rates of in-CCU mortality. The most frequent causes of death were intractable cardiogenic shock, brain death, respiratory failure, multiorgan failure, or hypotension. CONCLUSION: This study provides additional mortality information for the modern-day CCU and should help identify factors that may predict survival.
Authors: Courtney E Bennett; R Scott Wright; Jacob Jentzer; Ognjen Gajic; Dennis H Murphree; Joseph G Murphy; Sunil V Mankad; Brandon M Wiley; Malcolm R Bell; Gregory W Barsness Journal: J Crit Care Date: 2018-12-24 Impact factor: 3.425
Authors: Shashank S Sinha; Michael W Sjoding; Devraj Sukul; Hallie C Prescott; Theodore J Iwashyna; Hitinder S Gurm; Colin R Cooke; Brahmajee K Nallamothu Journal: Circ Cardiovasc Qual Outcomes Date: 2017-08
Authors: Erin A Bohula; Jason N Katz; Sean van Diepen; Carlos L Alviar; Vivian M Baird-Zars; Jeong-Gun Park; Christopher F Barnett; Gurjaspreet Bhattal; Gregory W Barsness; James A Burke; Paul C Cremer; Jennifer Cruz; Lori B Daniels; Andrew DeFilippis; Christopher B Granger; Steven Hollenberg; James M Horowitz; Norma Keller; Michael C Kontos; Patrick R Lawler; Venu Menon; Thomas S Metkus; Jason Ng; Ryan Orgel; Christopher B Overgaard; Nicholas Phreaner; Robert O Roswell; Steven P Schulman; R Jeffrey Snell; Michael A Solomon; Bradley Ternus; Wayne Tymchak; Fnu Vikram; David A Morrow Journal: JAMA Cardiol Date: 2019-09-01 Impact factor: 14.676
Authors: Mitchell Padkins; Thomas Breen; Nandan Anavekar; Sean van Diepen; Timothy D Henry; David A Baran; Gregory W Barsness; Kianoush Kashani; David R Holmes; Jacob C Jentzer Journal: ESC Heart Fail Date: 2020-09-10