Evidence map›Paper›PMID 32671805›Full record

ArticleCanadian journal of anaesthesia = Journal canadien d'anesthesie2020

Long-term mortality and costs following use of Impella® for mechanical circulatory support: a population-based cohort study.

Shannon M Fernando, Danial Qureshi, Peter Tanuseputro, Robert Talarico, Benjamin Hibbert, Rebecca Mathew, Bram Rochwerg, Emilie P Belley-Côté, Eddy Fan, Alain Combes and 5 more

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In one paragraph

Article in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 3 countries.

Shannon M FernandoDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada. sfernando@qmed.ca.ORCID http://orcid.org/0000-0003-4549-4289
Danial QureshiICES, Toronto, ON, Canada.
Peter TanuseputroICES, Toronto, ON, Canada.
Robert TalaricoICES, Toronto, ON, Canada.
Benjamin HibbertDivision of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Rebecca MathewDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Bram RochwergDepartment of Medicine, Division of Critical Care, McMaster University, Hamilton, ON, Canada.
Emilie P Belley-CôtéDepartment of Medicine, Division of Critical Care, McMaster University, Hamilton, ON, Canada.
Eddy FanInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Alain CombesMedical Intensive Care Unit, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Pitié Salpêtrière, Paris, France.
Daniel BrodieDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
Matthieu SchmidtMedical Intensive Care Unit, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Pitié Salpêtrière, Paris, France.
Trevor SimardDivision of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Pietro Di SantoDivision of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada.
Kwadwo KyeremantengDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
University of Ottawa · CAOttawa Hospital · CASorbonne Université · FRImpact · CANewYork–Presbyterian Hospital · USPopulation Health Research Institute · CAUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Impella® device is a form of mechanical circulatory support (MCS) used in critically ill adults with cardiogenic shock. We sought to evaluate short- and long-term outcomes following the use of Impella, including mortality, healthcare utilization, and costs.

methodsPopulation-based, retrospective cohort study of adult patients (≥ 16 yr) receiving Impella in Ontario, Canada (1 April 2012-31March 2019). We captured outcomes through linkage to health administrative databases. The primary outcome was mortality during hospitalization. Secondary outcomes included mortality at 30 days, 90 days, and one year following Impella insertion. We analyzed health system costs in Canadian dollars in the year following the date of the index admission, including the costs of inpatient admission.

resultsWe included 162 patients. Mean (standard deviation) age was 59.2 (14.5) yr, and 73.5% of patients were male. Median [interquartile range (IQR)] time to Impella insertion from date of hospital admission was 2 [1-9] days. In-hospital mortality was 56.8%, and a significant proportion of patients were bridged to a ventricular assist device (67.9%). Mortality at one year was 61.7%. Among hospital survivors, only 38.6% were discharged home independently. Median [IQR] total cost in the year following admission among all patients was $88,397 [32,718-225,628], of which $66,529 [22,789-183,165] was attributed to inpatient care.

conclusionsIn-hospital mortality among patients with cardiogenic shock receiving Impella is high, but with minimal increase at one year. While Impella patients accrued substantial costs, these largely reflected inpatient costs, and not costs incurred following hospital discharge.

Indexed as

Shock, CardiogenicAdultCohort StudiesHumansMaleOntarioRetrospective StudiesTreatment Outcomecardiogenic shockhealth servicesImpellamechanical circulatory support

Identifiers

PMID32671805
OpenAlexW3043776022

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.