BACKGROUND There are limited data depicting the prevalence and ramifications of acute limb ischemia (ALI) among cardiogenic shock (CS) patients. METHODS We employed data from the Cardiogenic Shock Working Group (CSWG), a consortium including 33 sites. We constructed a multi-variable logistic regression to examine the association between clinical factors and ALI, we generated another logistic regression model to ascertain the association of ALI with mortality. RESULTS There were 7,070 patients with CS and 399 (5.6%) developed ALI. Patients with ALI were more likely to be female (40.4% vs 29.4%) and have peripheral arterial disease (13.8% vs 8.3%). Stratified by maximum society for cardiovascular angiography & intervention (SCAI) shock stage, the rates of ALI were stage B 0.0%, stage C 1.8%, stage D 4.1%, and stage E 10.3%. Factors associated with higher risk for ALI included: peripheral vascular disease OR 2.24 (95% CI: 1.53-3.23; p < 0.01) and ≥2 mechanical circulatory support (MCS) devices OR 1.66 (95% CI: 1.24-2.21, p < 0.01). ALI was highest for venous-arterial extracorporeal membrane oxygenation (VA-ECMO) patients (11.6%) or VA-ECMO+ intra-aortic balloon pump (IABP)/Impella CP (16.6%) yet use of distal perfusion catheters was less than 50%. Mortality was 38.0% for CS patients without ALI but 57.4% for CS patients with ALI. ALI was significantly associated with mortality, adjusted OR 1.40 (95% CI 1.01-1.95, p < 0.01). CONCLUSIONS The rate of ALI was 6% among CS patients. Factors most associated with ALI include peripheral vascular disease and multiple MCS devices. The downstream ramifications of ALI were dire with a considerably higher risk of mortality.

中文翻译：

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心源性休克中急性肢体缺血的相关因素和下游临床结果：来自心源性休克工作组的见解。


背景 描述心源性休克 （CS） 患者急性肢体缺血 （ALI） 患病率和后果的数据有限。方法 我们采用了来自心源性休克工作组 （CSWG） 的数据，该工作组是一个包括 33 个站点的联盟。我们构建了一个多变量 logistic 回归来检查临床因素与 ALI 之间的关联，我们生成了另一个 logistic 回归模型来确定 ALI 与死亡率的关联。结果 有 7,070 例 CS 患者，其中 399 例 （5.6%） 发生 ALI。ALI 患者更可能是女性 （40.4% 对 29.4%） 和患有外周动脉疾病 （13.8% 对 8.3%）。按心血管血管造影与介入（SCAI）休克阶段的最大社会分层，ALI的发生率为B期0.0%，C期1.8%，D期4.1%，E期10.3%。与 ALI 风险较高相关的因素包括：外周血管疾病 OR 2.24 （95% CI： 1.53-3.23;p < 0.01） 和 ≥2 机械循环支持 （MCS） 设备 OR 1.66 （95% CI： 1.24-2.21，p < 0.01）。静脉-动脉体外膜肺氧合 （VA-ECMO） 患者 （11.6%） 或 VA-ECMO+ 主动脉内球囊反流 （IABP）/Impella CP （16.6%） 的 ALI 最高，但远端灌注导管的使用低于 50%。无 ALI 的 CS 患者的死亡率为 38.0%，而有 ALI 的 CS 患者的死亡率为 57.4%。ALI 与死亡率显著相关，校正 OR 1.40 （95% CI 1.01-1.95，p < 0.01）。结论 CS 患者 ALI 发生率为 6%。与 ALI 最相关的因素包括外周血管疾病和多个 MCS 装置。ALI 的下游影响是可怕的，死亡风险要高得多。