Summary

Implementation of shock teams and impact on the therapeutic approach and prognosis of cardiogenic shock in Spain

Marta Marcos-Mangas1, Pablo Jorge-Pérez2, Josep Comin-Colet3-5, Náyade del Prado6, Cristina Fernández6,7, Ana Viana Tejedor8, José Luis Bernal6,9, Rut Andrea4,10, Alessandro Sionis11, Javier Segovia-Cubero12, Jordi Bañeras13, M. Isabel Barrionuevo Sánchez3, José C Sánchez-Salado3, José González-Costello3-5, Oriol Alegre3, Manuel Martínez-Sellés14, Roberto Martín-Asenjo15, María Generosa Crespo-Leiro5,16, Joan Antoni Gómez-Hospital3-5, Javier Elola6,9, Albert Ariza-Solé3-5

Affiliation of the authors

1Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain. 2Hospital Universitario de Canarias, Tenerife, Spain. 3Servicio de Cardiología, Hospital Universitari de Bellvitge; IDIBELL. L’Hospitalet de Llobregat, Barcelona, Spain. 4Universitat de Barcelona (UB), Barcelona, Spain. 5Centro de Investigación Biomédica en Red, Enfermedades Cardiovasculares, CIBER-CV, Spain. 6Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain. 7Servicio de Medicina Preventiva, Área Sanitaria de Santiago de Compostela y Barbanza, Instituto de Investigaciones Sanitarias de Santiago (IDIS), Santiago de Compostela, Spain. 8Servicio de Cardiología, Hospital Universitario Clínico San Carlos, Madrid, Spain. Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. 9Cátedra IMAS – Universidad Rey Juan Carlos, Madrid, Spain. 10Sección de Cuidados Cardiacos Agudos, Servicio de Cardiología, Institut Clinic Cardiovascular, Hospital Clínic de Barcelona, Barcelona, Spain. 11Unidad de Cuidados Agudos Cardiológicos, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Institut de Recerca II-B Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain. 12Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain. 13Hospital de la Vall d’Hebron, Barcelona, Spain. 14Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Instituto de Salud Carlos III, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea. Facultad de Medicina, Universidad Complutense, Madrid, Spain. 15Hospital Universitario 12 de Octubre, Madrid. Instituto de Investigación Sanitaria Hospital 12 de Octubre (IMAS12), Madrid, Spain. 16Complexo Hospitalario Universitario de A Coruña. INIBIC. UDC. CIBERCV, Spain.

DOI

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Quote

Marcos-Mangas M, Jorge-Pérez P, Comin-Colet J, del Prado N, Fernández C, Viana Tejedor A, et al. Implementation of shock teams and impact on the therapeutic approach and prognosis of cardiogenic shock in Spain. Emergencias. 2026;38:261-8

Summary

Objectives.

There are no data on the implementation of shock teams (ST) or their impact on cardiogenic shock (CS) in Spain.

Methods.

We conducted a retrospective observational study including episodes of CS (2016–2022) from hospitals within the Spanish National Health System with availability of an Interventional Cardiology Unit. The population was divided into a) patients hospitalized in centers with ST (CS-ST) and b) patients hospitalized in centers without ST (CSNST). Furthermore, the availability of a cardiac intensive care unit (CICU), cardiac surgery, heart transplant program, and volume of CS cases at each center were recorded. The outcome variable was the in-hospital mortality rate.

Results.

A total of 15,879 episodes were analyzed, 32% (5,095) of which corresponded to the CS-ST group. The proportion of  enters with ST availability increased progressively from 7% in 2016 to 39% in 2022. Patients from the CS-ST group were younger (68 vs 71 years, P < .001) and more frequently underwent mechanical ventilation, renal replacement therapy, and circulatory support (P < .001), showing a higher rate of acute kidney failure and stroke and longer lengths of stay (12 days vs 9 days, P < .001). Care in centers with ST (OR, 0.86; 95% CI, 0.77–0.96; P = .005) and CICU (OR, 0.82; 95% CI, 0.69–0.98; P < .033) was significantly associated with a lower mortality rate.

Conclusions.

The availability of ST has expanded in our setting. Patients admitted to centers with ST are managed more invasively, with a lower in-hospital mortality rate despite a higher rate of complications

 

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