Utilization and Impact of Right Heart Catheterization on In-hospital Mortality, Length of hospital Stay and 30 Day Readmission in Patients Admitted with Cardiogenic Shock - Review of Large, National, Multicenter Database

Background We hypothesize that early right heart catheterization (RHC)/pulmonary artery catheter (PAC) placement in cardiogenic shock (CS) patients may allow to better target treatment, reduce length of stay (LOC), in-hospital mortality and readmission rates. Methods Using the National Readmission Database (NRD) we identified CS index admissions, in-hospital mortality, LOC and 30-day readmissions between January and November of 2014. The utilization and timing of RHC/PAC and its influence on in-hospital mortality, LOC and 30-day readmission rates were analyzed. Results A total of 11591 index CS hospital admissions were identified (mean age 62.7 ±15 years; females 32.6%). The overall in-hospital mortality among the CS patients was 27% and median LOC was 13.0 [8.0, 21.0] days. 3487 (33%) patients had readmissions within 30 days (30%; females). During the index hospitalization, 3390 (30%) CS patients underwent RHC/PAC. More men and young patients underwent RHC/PAC (71% Vs. 66% and 57.5±14.4 years Vs. 65.2±15 years respectively; P Conclusions Among the patients admitted with CS, utilization of RHC/PAC may reduce the mortality rates. Furthermore, those who receive early (