Abstract 12808: Use of Intra-Aortic Balloon Pump in COVID-19 Patients With Cardiogenic Shock and Associated Mortality Risk

Abstract

Introduction: While some past studies have hinted that intra-aortic balloon pump (IABP) may not influence mortality in cardiogenic shock(CS) patients, the impact and the predictors of its use among COVID-19 admissions with CS are unknown. Methods: We analyzed COVID-19-positive adults from the 2020 National Inpatient Sample hospitalized between April 1st, 2020, and December 31st, 2020. The presence of CS and the use of IABP were identified. Factors influencing the preference of IABP in CS cases were evaluated via logistic regression models. Results: We found 9665 COVID-19 patients with CS, and 430 patients (4.4%) necessitated the use of IABP. COVID-19 patients with CS requiring IABP were younger (mean age 61.38 years) than those not using IABP(mean age 66.28 years). IABP use was less likely to involve adults with prior MI (aOR 0.549, p=0.031), ages ≥60 years (aOR 0.574, p<0.01), hypertension (aOR 0.638,p<0.01), obesity (aOR 0.474, p<0.01), events of acute kidney injury (aOR 0.626, p<0.01), weekend hospitalizations (aOR 0.724, p<0.01), or females (vs. Males, aOR 0.759, p=0.02). However, higher odds of IABP use in CS were seen among those with complete AV block (aOR 5.581, p<0.01) and smokers (aOR 1.427, p<0.01). No racial differences in use were seen and those covered with private insurances were likelier to use IABP than Medicare-insured patients (aOR 2.077, p<0.01). The mortality rate among CS patients using IABP was 3.0%, while those not using IABP had a worse outcome (mortality rate 6.9%, aOR mortality in IABP users vs. non-users 0.458, 95% CI 0.369-0.569, p<0.01). Conclusions: Our study shows that COVID-19 adults with CS using IABP were younger and had a lower mortality rate. Factors such as past MI, ages ≥60 years, hypertension, obesity, AKI, female sex, and weekend hospitalizations were linked with fewer use. At the same time, those with complete heart block, Private insurance forms, and smokers were more likely to use IABP in CS.