PMID- 27279128
OWN - NLM
STAT- MEDLINE
DCOM- 20180503
LR  - 20180503
IS  - 2048-8734 (Electronic)
IS  - 2048-8726 (Linking)
VI  - 6
IP  - 5
DP  - 2017 Aug
TI  - Prognostic implications of fluid balance in ST elevation myocardial infarction 
      complicated by cardiogenic shock.
PG  - 462-467
LID - 10.1177/2048872616652312 [doi]
AB  - BACKGROUND: Positive fluid balance has been associated with adverse outcomes in 
      patients admitted to general intensive care units. We analysed the relationship 
      between a positive fluid balance and its persistence over time in terms of 
      in-hospital outcomes among ST elevation myocardial infarction (STEMI) patients 
      complicated by cardiogenic shock. METHODS: We retrospectively studied fluid 
      intake and output for 96 hours following hospital admission in 48 consecutive 
      adult patients with STEMI complicated by cardiogenic shock, all undergoing 
      primary angioplasty. Daily and accumulated fluid balance was registered at up to 
      96 hours following admission. The cohort was stratified into two groups based on 
      the presence or absence of positive fluid balance on day 4. Patients' records 
      were assessed for in-hospital adverse outcomes, as well as 30-day all-cause 
      mortality. RESULTS: A positive fluid balance was present in 19/48 patients (40%). 
      Patients with positive fluid balance were older and more likely to be treated by 
      intra-aortic balloon counter-pulsation and antibiotics. These patients were more 
      likely to develop acute kidney injury and to need new intubation and were less 
      likely to have renal function recovery as well as successful weaning from 
      mechanical ventilation ( p < 0.05 for all). Patients with positive fluid balance 
      had higher 30-day mortality (68% vs. 10%; p < 0.001). In a multivariate Cox 
      regression model, for every 1-L increase in positive fluid balance, the adjusted 
      risk for 30-day mortality increased by 24% (hazard ratio: 1.24, 95% confidence 
      interval: 1.07-1.42; p = 0.003). CONCLUSIONS: A positive fluid balance was 
      strongly associated with higher 30-day mortality in STEMI complicated by 
      cardiogenic shock.
FAU - Arbel, Yaron
AU  - Arbel Y
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Mass, Ronen
AU  - Mass R
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Ziv-Baran, Tomer
AU  - Ziv-Baran T
AD  - 2 School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel 
      Aviv, Israel.
FAU - Khoury, Shafik
AU  - Khoury S
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Margolis, Gilad
AU  - Margolis G
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Sadeh, Ben
AU  - Sadeh B
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Flint, Nir
AU  - Flint N
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Ben-Shoshan, Jeremy
AU  - Ben-Shoshan J
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Finn, Talya
AU  - Finn T
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Keren, Gad
AU  - Keren G
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
FAU - Shacham, Yacov
AU  - Shacham Y
AD  - 1 Department of Cardiology, Tel Aviv Sourasky Medical Center affiliated to the 
      Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20160608
PL  - England
TA  - Eur Heart J Acute Cardiovasc Care
JT  - European heart journal. Acute cardiovascular care
JID - 101591369
SB  - IM
MH  - Aged
MH  - Cause of Death/trends
MH  - Coronary Care Units
MH  - Female
MH  - Follow-Up Studies
MH  - Hospital Mortality/trends
MH  - Humans
MH  - *Inpatients
MH  - Israel/epidemiology
MH  - Male
MH  - *Percutaneous Coronary Intervention
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/complications/*metabolism/surgery
MH  - Shock, Cardiogenic/etiology/*metabolism/mortality
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Water-Electrolyte Balance/physiology
OTO - NOTNLM
OT  - Fluid balance
OT  - cardiogenic shock
OT  - mortality
OT  - myocardial infarction
EDAT- 2016/06/10 06:00
MHDA- 2018/05/04 06:00
CRDT- 2016/06/10 06:00
PHST- 2016/06/10 06:00 [pubmed]
PHST- 2018/05/04 06:00 [medline]
PHST- 2016/06/10 06:00 [entrez]
AID - 2048872616652312 [pii]
AID - 10.1177/2048872616652312 [doi]
PST - ppublish
SO  - Eur Heart J Acute Cardiovasc Care. 2017 Aug;6(5):462-467. doi: 
      10.1177/2048872616652312. Epub 2016 Jun 8.