Abstract P579: Predictors of Cardiogenic Shock Among Patients With Alcohol Abuse Undergoing SAVR in the United States

Abstract

Introduction: While alcohol is a modifiable cause of cardiac complications, its use is on the rise. We sought to understand the predictors of cardiogenic shock (CS) among patients with a history of alcohol abuse undergoing surgical aortic valve replacement (SAVR). Hypothesis: We assessed the hypothesis that patients with alcohol abuse undergoing SAVR have various predictors of CS during hospitalization. Method: We retrospectively analyzed cases of SAVR among those with a diagnosis of alcohol abuse from the 2019 National Inpatient Sample. Logistic models helped find the adjusted odds ratio (aOR) of CS. Results: In total, 1980 patients with alcohol abuse underwent SAVR, and 10.9% (215 cases) reported an episode of CS. Blacks (aOR 2.553, CI 1.354-4.814, p=0.004) and races other than White, Black, or Hispanic (aOR 3.136, CI 1.29-7.62, p=0.012) showed higher odds of CS compared to Whites. While Medicare covered the highest proportion of CS patients (39.5%), Medicaid beneficiaries were least likely to develop CS (aOR 0.241, CI 0.132 -0.442, p<0.01) compared to those on Medicare. Our study also found that patients with anemia (aOR 10.317, CI 5.234-20.334, p<0.01), acute kidney injury (aOR 3.921, CI 2.54-6.052, p<0.01), and cirrhosis (aOR 4.587, CI 2.719-7.736, p<0.01), had higher odds of reporting CS. However, those with underlying obesity (aOR 0.237, CI 0.126-0.447, p<0.01), diabetes mellitus (aOR 0.344, CI 0.197-0.602, p<0.01), and hypertension (aOR 0.436, CI 0.264-0.721, p<0.01) were less likely to do so. Unfortunately, 25 patients with CS (11.6%) did not survive their hospitalization (aOR 13.771, 95% CI 5.526-34.317, p<0.01). Conclusion: In our analysis, we found that anemia, acute kidney injury, cirrhosis, Black race, and Races other than Black, White or Hispanic are possibly linked to a higher incidence of CS, while obesity, diabetes mellitus, hypertension, and being a Medicaid beneficiary are associated with a lower incidence of CS. Further studies and changes in protocols may help identify them early and improve outcomes.