BackgroundData on shock severity and bleeding events in patients with temporary mechanical circulatory support (tMCS) are limited. We investigated the relationship between the Society for Cardiovascular Angiography and Interventions (SCAI) shock stage classification and bleeding events in patients with tMCS.MethodsWe evaluated the data of 285 consecutive patients with tMCS who were admitted to our institution between June 2019 and May 2022. At the time of tMCS initiation, 81 patients (28.4%) were in SCAI stage A, 38 (13.3%) in stage B, 69 (24.2%) in stage C, 33 (11.6%) in stage D, and 64 (22.5%) in stage E. Multivariable logistic regression modeling was used to assess the association between the SCAI shock stage and in‐hospital bleeding events.ResultsIn‐hospital bleeding occurred in 100 patients (35.1%). The bleeding event rate increased incrementally across the SCAI shock stages (stage A, 11.1%; stage B, 15.8%; stage C, 37.7%; stage D, 54.6%; stage E, 64.1%). In‐hospital bleeding was associated with the SCAI shock stage (p < 0.001). Compared with stage A, the adjusted odds ratios for in‐hospital bleeding were 1.48 (95% confidence interval [CI] 0.47–4.66), 6.47 (95% CI 2.61–10.66), 11.59 (95% CI 3.77–35.64), and 7.85 (95% CI 2.51–24.55) for stages B, C, D, and E, respectively.ConclusionsThe SCAI shock stage predicted subsequent bleeding events in patients with tMCS. This simple scheme may be useful for tailored risk‐based clinical assessment and management of patients with tMCS.

中文翻译：

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心源性休克的严重程度可预测临时机械循环支持患者的出血事件


背景关于临时机械循环支持（tMCS）患者休克严重程度和出血事件的数据有限。我们调查了心血管血管造影和干预协会 (SCAI) 休克分期分类与 tMCS 患者出血事件之间的关系。方法我们评估了 2019 年 6 月至 2022 年 5 月期间入住我们机构的连续 285 名 tMCS 患者的数据。 tMCS 开始时，81 例患者 (28.4%) 处于 SCAI A 期，38 例 (13.3%) 处于 B 期，69 例 (24.2%) 处于 C 期，33 例 (11.6%) 处于 D 期，64 例 (22.5%) 处于 SCAI 期）在 E 期。采用多变量逻辑回归模型评估 SCAI 休克分期与院内出血事件之间的关联。结果 100 名患者（35.1%）发生院内出血。 SCAI 休克阶段的出血事件发生率逐渐增加（A 期，11.1%；B 期，15.8%；C 期，37.7%；D 期，54.6%；E 期，64.1%）。院内出血与 SCAI 休克阶段相关 (p < 0.001)。与 A 期相比，院内出血的调整后比值比分别为 1.48（95% 置信区间 [CI] 0.47-4.66）、6.47（95% CI 2.61-10.66）、11.59（95% CI 3.77-35.64）和B、C、D 和 E 期分别为 7.85 (95% CI 2.51–24.55)。结论 SCAI 休克分期预测 tMCS 患者随后的出血事件。这个简单的方案可能有助于针对 tMCS 患者进行基于风险的定制临床评估和管理。