Correlation of Left Ventricular Function and CardShock Risk Score with Altered Mental State in Cardiogenic Shock Patient Treated with Mechanical Ventilation
Author : D.H. Karimullah, L.H. Adrian, F.W. Nugroho, S. Anjarwani
Upload Date : 19-04-2018
Background: Altered mental status is one of hypoperfusion signs in cardiogenic shock, the most complex form of acute heart failure.
Aim : This study was to investigate the prevalence and factors associated with altered mental status in patients with cardiogenic shock who were treated with mechanical ventilation
Method: Mental status was assessed at presentation of shock in 72 adult cardiogenic shock patients admitted to CVCU, tertiary hospital, Dr. Saiful Anwar General Hospital, Malang East Java, Indonesia. This study was single center, retrospective, observational study. Clinical picture, biochemical variables, score modality, and short-term in hospital mortality were compared between patients presenting with altered and normal mental status.?
Result : Altered mental status was detected in 37 (51%) patients, whereas 35 (49%) patients had normal mental status. Patients with altered mental status were have more decrease of left ventricle function (odds ratio / OR 9.213, p value 0.023, CI 95%). Altered mental status was associated with increase of serum lactate (OR 0.543, p value 0.043, CI 95%) as well as with high value of CardShock risk score (OR 8.752, p value 0.001, CI 95%). After multivariable regression, CardShock risk score (adjusted OR 4.244, p 0.000, CI 95%) and low ejection fraction (adjusted OR 9.213, p: 0.023, CI 95%) showed as independent risk factors associated with altered mental status.
Conclusion : Decrease of left ventricular function and high CardShock risk score are independent risk factors for the occurrence of altered mental state in cardiogenic shock patients treated with mechanical ventilation.
KEYWORDS : Altered mental state, cardiogenic shock, CardShock risk score