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# Cardiogenic shock deaths fall stepwise with hospital cardiac capability in US data
- URL: https://www.coios.me/cardiogenic-shock-deaths-fall-stepwise-with-hospital/
- Published: 2026-09-17T09:24:25.000Z
- Updated: 2026-09-17T09:24:25.000Z
- Description: Across an estimated 1.18 million US cardiogenic shock hospitalisations from 2016 to 2022, crude in-hospital mortality fell from 64.4% at hospitals without percutaneous coronary intervention to 36.5% at transplant and LVAD centres, with the gradient persisting after adjustment.
- Author: Daniel Ryan
- Tags: Healthcare today, Cardiovascular disease, United States, #peer-reviewed, #confirms, #item, #source-2026-09

Using the National Inpatient Sample for 2016-2022, hospitals were graded into five tiers of cardiac capability and in-hospital mortality after cardiogenic shock was modelled with a latent construct for acute physiological severity (cardiac arrest, acute kidney and liver injury, ventilation). Crude mortality declined from 64.4% at non-PCI hospitals to 36.5% at transplant/LVAD centres, and adjusted odds of death were roughly a third of tier 1 at higher tiers (tier 4 OR 0.34, 95% CI 0.30-0.38). Transfer-in status carried higher mortality (OR 1.36) but the penalty was attenuated at surgical and transplant centres.

*Why it is interesting: Puts a size on the institutional gradient in cardiogenic shock survival, though administrative data cannot separate capability from case selection and transfer decisions.*

Source

[Circulation. Heart failure, 2026-09-15](https://doi.org/10.1161/circheartfailure.126.014546?ref=coios.me)

DOI

10.1161/circheartfailure.126.014546

Type

Peer-reviewed article

Design

Retrospective analysis of US National Inpatient Sample, 2016-2022, \~1,177,180 cardiogenic shock hospitalisations, hospitals in five capability tiers, structural equation model with latent severity construct

Verdict

Confirms prior evidence

Driver

[Cardiovascular disease](https://www.coios.me/d-cardiovascular/)