In-Hospital Mortality, Acute Kidney Injury, Length of Stay and Cost among Patients with Acute Myocardial Infarction Related Cardiogenic Shock Complicated with Nosocomial Infections: Analysis of National Inpatient Sample Data

Purpose In-hospital mortality of patients with cardiogenic shock complicating ST-elevation myocardial infarction (STEMI-CS) ranges from 30% to 50%. The impact of nosocomial infection(NI) is not well addressed in these patients. Methods We queried the 2005-2014 Nationwide Inpatient Sample database to identify patients with STEMI-CS. Incidence of hospital-mortality, acute kidney injury (AKI), length of stay (LOS), cost of hospitalization and NI such as bloodstream infections due to central venous catheters (BI), bacteremia, ventilator-associated pneumonia (VAP), and clostridium difficile (CDI) infection among patients with and without mechanical circulatory support (MCS) use (intra-aortic balloon pump [IABP], Impella/TandemHeart [PVAD], and extra corporeal membrane oxygenation [ECMO]) were analyzed. Results We identified 172486 cases of STEMI-CS, of which 53% required MCS. Among STEMI-CS cases 6104 (3.5%) developed NI and 3977 cases required MCS. The rates of NI were increased among patients with MCS (p Conclusion NI are more frequent among patients with STEMI-CS requiring MCS and are associated with increased rates of AKI, LOS, and costs, but do not affect in-hospital mortality.