Demographics, Diagnoses, Care Patterns, and Outcomes of Patients Admitted to a Cardiac Intensive Care Unit in a High-Volume Referral Tertiary Center in Latin America

Main Article Content

Leandro Bono, MD Luciana Puente, MD Jorge L Szarfer, MD http://orcid.org/0000-0003-1254-3929 Mariano Napoli Llobera, MD Eugenia Doppler, MD Maria Laura Estrella, MD Alejandro Kim, MD Ana Laura Mori, MD Patricia Arce, MD Juan Gagliardi, Ph D http://orcid.org/0000-0003-3701-7220

Abstract

Background


Single and multi-center studies have described substantial changes in the landscape of health care in cardiac intensive care units (CICU). Few reports have quantitatively characterized current diagnoses in a contemporary CICU in Latin America.


This study aims to describe demographics, diagnoses, care patterns, and outcomes in patients admitted to a CICU in a high-volume center in South America.


Methods


A total of 1629 consecutive patients admitted to CICU from December 2017 to April 2020 were included in a prospective registry. The variables analyzed included demographic data, admission and final diagnoses, management, and outcomes.


Results


Among 1629 participants, 32.4% were women, and the median age was 62 years (53-71). Admissions were due to primary cardiac causes in 1335 (81.9%), postsurgical care in 13.3%, and a combination of general and cardiac diagnoses in 4.8% of patients. The most frequent diagnosis on admission was acute coronary syndrome (ACS) (35.7%). Primary reasons for CICU admission were postprocedural observation (PPO) (31.8%), diagnosed or suspected ACS (31.7%), heart failure (10.1%), postsurgical management after cardiovascular surgery (8.9%), arrhythmia (5.8%), shock (4.5%) and cardiac arrest (CA) (1.2%). Advanced CICU therapy requirements were ventilatory assistance (19.3%) and vasoactive or inotropic drug use (19.6%). The overall mortality rate was 6.4%. Admission diagnoses associated with the highest mortality rates were CA (52.6%), noncardiogenic shock (39.5%), and cardiogenic shock (32.3%). Notably, patients admitted solely for PPO had a mortality rate of 0.8%.


Conclusions


In a contemporary CICU from a high-volume reference center in South America, the most frequent diagnosis was an ACS, although it represented only one-third of the admissions.


One-fifth of admissions required advanced CICU therapies. CA and shock on admission carried a poor prognosis. We identified PPO as a substantially low-risk population.

Article Details

How to Cite
BONO, Leandro et al. Demographics, Diagnoses, Care Patterns, and Outcomes of Patients Admitted to a Cardiac Intensive Care Unit in a High-Volume Referral Tertiary Center in Latin America. Medical Research Archives, [S.l.], v. 8, n. 9, sep. 2020. ISSN 2375-1924. Available at: <https://journals.ke-i.org/mra/article/view/2226>. Date accessed: 27 oct. 2020. doi: https://doi.org/10.18103/mra.v8i9.2226.
Section
Research Articles

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