OR10-4 | Extracorporeal Membranous Oxygenation vs Impella Support in Cardiogenic Shock Secondary to Myocarditis: An Analysis of the Nationwide Inpatient Sample

The use of mechanical circulatory support in cardiogenic shock (CS) is increasing, with relative safety and efficacy being undetermined. We aimed to analyze the use of extracorporeal membranous oxygenation (ECMO) and impella in CS secondary to myocarditis (MC). We identified hospitalizations with MC and concomitant CS. We further divided these hospitalizations based on if they received ECMO vs impella support using their International Classification of Disease - 10 Clinical Modification (ICD-10-CM) codes from the National Inpatient Sample (NIS) Database 2016-2020. We studied primary disease outcomes including mortality, length of stay (LOS) and total hospital charges (THC). Multivariate logistic regression and linear regression analyses were used to adjust for possible confounders. Out of the 12,834 hospitalizations with MC, 1475 (11%) developed CS. Out of 1475 with CS 145 (10%) received ECMO, and 235 (16%) received impella. Those who received ECMO were younger than those receiving impella, 32.5 years vs 42.4 years. Interestingly, no significant difference was seen in ECMO vs impella for mortality (Adjusted odds ratio (aOR): 0.47, [95% Confidence Interval (CI) 0.04-4.57, p = 0.52], THC of $178300 ( 95% CI: 68965.3-333051, p=0.49), and LOS (coefficient: 2.75, 95% CI 8.54-14.1, p = 0.63). Additionally, no significant difference was seen in secondary outcomes including acute kidney injury (aOR: 0.43, CI: 0.08-2.37, p = 0.33), cardiac tamponade (aOR: 0.26, CI: 0.02-3.38, p = 0.30), or blood transfusion (aOR: 0.30, CI: 0.04-2.10, p = 0.22). Patients admitted with CS secondary to myocarditis received impella more often than ECMO. No significant difference was found in primary outcomes including mortality, THC, and LOS. Additionally no significant difference was found in secondary outcomes including acute kidney injury, blood transfusion, cardiac tamponade, ischemic stroke or cardiac arrest. This study offers initial insights, yet definitive conclusions are constrained. Further trials are warranted to systematically compare varied mechanical circulatory support interventions across diverse causes of CS.