Predictors of 30-Day Mortality in Patients with Heart Failure Presenting with Cardiogenic Shock

Abstract

Objectives: To identify clinical predictors of mortality among heart failure patients presenting with cardiogenic shock.

Methodology: This prospective cohort study was conducted from April 2020 to March 2021, involving 201 heart failure patients who presented to Rouhani Hospital with cardiogenic shock. Demographic and clinical data were collected from medical records, and in-hospital or 30-day mortality was tracked through follow-up phone calls. Statistical analysis was performed using SPSS V22.0.

Results: Among the 201 patients, the average age was 69 ± 15.71 years, with 57.2% being male. Within this cohort, 29 patients (14.5%) died within 30 days post-discharge, while 66 patients (33.1%) succumbed during hospitalization. Mortality rates were significantly higher among patients with underlying diabetes (p = 0.005) and coronary artery disease (p = 0.023). A mean difference in blood lactate levels of -1.45 was observed (p < 0.05). There was no significant difference in the duration from symptom onset to hospitalization between the two groups (p = 0.102). Key predictors of mortality included confusion and elevated blood lactate levels.

Conclusion: A history of diabetes is a critical factor in predicting mortality among heart failure patients with cardiogenic shock, while blood pressure at the time of admission does not have the same predictive value. Additionally, the presence of confusion and increased lactate levels were significant predictors of poor outcomes in this population.