Original StudyOutcomes, Temporal Trends, and Resource Utilization in Ischemic versus Nonischemic Cardiogenic ShockLemor, Alejandro MD, MS*; Hosseini Dehkordi, Seyed Hamed MD†; Alrayes, Hussayn DO*; Cowger, Jennifer MD, MS*; Naidu, Srihari S. MD‡; Villablanca, Pedro A. MD*; Basir, Mir B DO*; O’Neill, William MD* Author Information From the *Department of Cardiology, Henry Ford Health System, Detroit, MI †Department of Cardiology, The University of Kansas Health System, Kansas City, KS ‡Department of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, NY. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.critpathcardio.com). Reprints: Alejandro Lemor, MD, MS, Cardiovascular Department, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202. Email: [email protected]. Critical Pathways in Cardiology 21(1):p 11-17, March 2022. | DOI: 10.1097/HPC.0000000000000272 Buy SDC Metrics Abstract Cardiogenic shock (CS) is associated with significant morbidity and mortality. Differentiating the etiologic factors driving CS has epidemiological significance and aids in optimization of therapeutic strategies, prognostication, and resource utilization. The aim herein is to investigate the epidemiology and clinical outcomes of CS in those with ischemic and nonischemic CS etiologies. Using International Classification of Diseases codes, we queried the national inpatient sample for CS hospitalization from 2007 to 2018 and divided the study sample into cohorts of ischemic (I-CS) and nonischemic cardiogenic shock (NI-CS). We then compared the primary outcome of in-hospital mortality between these 2 cohorts. Two groups of secondary outcomes (clinical and procedural) were also assessed between the 2 cohorts. CS was present in 557,860 hospitalizations; 84% of these were I-CS and 15.8% NI-CS. Patients with I-CS were older, more commonly males, with more risk factors for coronary artery disease (P < 0.05). NI-CS had higher prevalence of preexisting systolic heart failure and atrial fibrillation. The in-hospital mortality was significantly higher in patients with I-CS (32.2% vs. 29.5%, adjusted odds ratio 1.10, P < 0.001). Frequencies of acute ischemic stroke, mechanical ventilation, ventricular arrhythmias, and vascular complications were higher in I-CS versus NI-CS, while acute kidney injury and acute liver failure were more common in NI-CS (P < 0.05). The use of mechanical circulatory support devices was higher in the I-CS group. In conclusion, patients with I-CS comprise the vast majority of CS and are associated with higher mortality and higher resource utilization. Conversely, patients with NI-CS appear to have higher survival but with a higher prevalence of end-organ dysfunction. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.