ArticleResearch square2026
Comparative Outcomes of Direct Impella Use vs. Intra-Aortic Balloon Pump (IABP)-to- Impella Escalation Strategy in Cardiogenic Shock: Insights from the National Inpatient Sample.
Article in Research square, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundImpella and IABP are widely used temporary mechanical circulatory support devices in cardiogenic shock (CS). While the Impella is used as an initial support or after IABP as escalation strategy, comparative data on these two strategies remains limited.
methodsUsing ICD-10 codes in the 2016-2022National Inpatient Sample (NIS) database, we identified patients with primary diagnosis of CS who received Impella support and divided in two groups: direct Impella use and escalation from IABP to Impella. Propensity score matching was performed to adjust for confounding.
resultsAmong 107,007 patients were included, 700 (6.5%) underwent IABP-to-Impella escalation strategy. Before matching, the direct Impella use had significantly shorter length-of-stay (LOS) 11.4±13.97 vs. 19.28±20.70 days,
conclusionsIn cardiogenic shock, direct and escalation Impella use were associated with similar in-hospital mortality, but direct use was linked to shorter hospital stays and lower costs, highlighting potential benefits in resource utilization and efficiency.
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