Observational studyShock (Augusta, Ga.)2019
Etiology of Shock in the Emergency Department: A 12-Year Population-Based Cohort Study.
Observational study in Shock (Augusta, Ga.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 47 citations in OpenAlex.
- Ultrasound guidance versus conventional technique for radial arterial puncture in patients with shock in the emergency department: a randomized controlled trial.BMC emergency medicine · 2026Trial
- Inter-clinician diagnostic agreement of shock etiology: a multicenter observational study.Health information science and systems · 2026Article
- The Role of PoCUS in the Diagnosis and Early Monitoring of Cardiogenic Shock in the Emergency Department: A Narrative Review.Reviews in cardiovascular medicine · 2026Review
- Hemorrhagic Shock and the "Lethal Diamond".ATS scholar · 2026Article
- Mortality prediction using the Shock Index and Modified Shock Index in the Emergency Department.Revista brasileira de enfermagem · 2026Article
- Obstructive shock caused by infection of a mediastinal tumor: a case report and literature review.Frontiers in medicine · 2026Article
- Cardiogenic Shock Systems of Care Best Practices. Part 1: Prehospital and Emergency Department Evaluation and Management.US cardiology · 2026Review
- Incidence of mortality and predictors among patients with shock managed in the emergency room of a tertiary hospital in Ethiopia.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- Contemporary reperfusion therapies in patients with intermediate- and high-risk pulmonary embolism.Thrombosis research · 2025Article
- Observational
- Early initiated noradrenaline versus fluid therapy for hypotension and shock in the emergency department (VASOSHOCK): a protocol for a pragmatic, multi-center, superiority, randomized controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- The Outcomes of the Initial Misclassification of Undifferentiated Hypotension in the Emergency Department: A Prospective Observational Study.Journal of clinical medicine · 2024Article
- [Distributive shock].Die Anaesthesiologie · 2023Article
- Early Recognition and Risk Stratification in Cardiogenic Shock: Well Begun Is Half Done.Journal of clinical medicine · 2023Review
- Multifactorial Shock: A Neglected Situation in Polytrauma Patients.Journal of clinical medicine · 2022Article
- Classification of Blood Volume Decompensation State via Machine Learning Analysis of Multi-Modal Wearable-Compatible Physiological Signals.Sensors (Basel, Switzerland) · 2022Article
- Principles of Hypotensive Shock: A Video Introduction to Pathophysiology and Treatment Strategies.Journal of education & teaching in emergency medicine · 2022Article
- Organ failure, aetiology and 7-day all-cause mortality among acute adult patients on arrival to an emergency department: a hospital-based cohort study.European journal of emergency medicine : official journal of the European Society for Emergency Medicine · 2021Observational
- Shock in China 2018 (SIC-study): a cross-sectional survey.Annals of translational medicine · 2021Article
- Community Acquired Urosepsis: A surgical intensive care Experience.Qatar medical journal · 2020Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe knowledge of the etiology and associated mortality of undifferentiated shock in the emergency department (ED) is limited. We aimed to describe the etiology-based proportions and incidence rates (IR) of shock, as well as the associated mortality in the ED.
methodsPopulation-based cohort study at a University Hospital ED in Denmark from January 1, 2000, to December 31, 2011. Patients aged ≥18 years living in the ED-catchment area (N = 225,000) with a first-time ED presentation with shock (n = 1,553) defined as hypotension (systolic blood pressure ≤100 mm Hg) and ≥1 organ failures were included. Discharge diagnoses defined the etiology and were grouped as follows: distributive septic shock (SS), distributive non-septic shock (NS), cardiogenic shock (CS), hypovolemic shock (HS), obstructive shock (OS), and other conditions (OC). Outcomes were etiology-based characteristics, annual IR per 100,000 person-years at risk (95% confidence intervals [CIs]), mortality at 0 to 7-, and 0 to 90 days (95% CIs) and hazard rates (HR) at 0 to 7, 8 to 90 days (95% CIs). Poisson and Cox regression models were used for analyses.
resultsAmong 1,553 shock patients: 423 (27.2%) had SS, 363 (23.4%) NS, 217 (14.0%) CS, 479 (30.8%) HS, 14 (0.9%) OS, and 57 (3.7%) OC. The corresponding IRs were 16.2/100,000 (95% CI: 14.8-17.9), 13.9/100,000 (95% CI: 12.6-15.4), 8.3/100,000 (95% CI: 7.3-9.5), 18.4/100,000 (95% CI: 16.8-20.1), 0.5/100,000 (95% CI: 0.3-0.9), and 2.2/100,000 (95% CI: 1.7-2.8). SS IR increased from 8.4 to 28.5/100,000 during the period 2000 to 2011. Accordingly, the 7-, and 90-day mortalities of SS, NS, CS, and HS were 30.3% (95% CI: 25.9-34.7) and 56.2% (95% CI: 50.7-61.5), 12.7% (95% CI: 9.2-16.1) and 22.6% (95% CI: 18.1-27.7), 34.6% (95% CI: 28.2-40.9) and 52.3% (95% CI: 44.6-59.8), 19.2% (95% CI: 15.7-22.7), and 36.8% (95% CI: 33.3-43.3). SS (HR = 1.46 [95% CI: 1.03-2.07]), and CS (HR = 2.15 [95% CI: 1.47-3.13]) were independent predictors of death within 0 to 7 days, whereas SS was a predictor within 8 to 90 days (HR = 1.66 [95% CI: 1.14-2.42]).
conclusionHS and SS are frequent etiological characteristics followed by NS and CS, whereas OS is a rare condition. We confirm the increasing trend of SS, as previously reported. Seven-day mortality ranged from 12.7% to 34.6%, while 90-day mortality ranged from 22.6% to 56.2%. The underlying etiology was an independent predictor of mortality.
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