D-118 | Admission Hemoglobin Stratifies Survival and Advanced Therapy Utilization in Cardiogenic Shock

Background: Lower hemoglobin (Hb) may worsen cardiogenic shock (CS) by impairing oxygen delivery, but its prognostic significance in CS patients is not well defined.We studied the relationship between admission Hb and outcomes in a large hospital system.Methods: This retrospective study used the TriNetX platform.Adult CS patients were divided into two groups: Hb 10 g/dL and Hb <10 g/ dL.Before matching, 2,650 patients were in the Hb 10 group and 2,270 in the Hb <10 group.Propensity score matching accounted for age, sex, atrial fibrillation, coronary artery disease, chronic kidney disease, and cirrhosis.Outcomes were assessed using Kaplan-Meier survival analysis and measures of association.Results: After matching, 3,880 patients remained (1,950 with Hb 10 and 1,930 with Hb <10).Patients with Hb <10 experienced significantly higher in-hospital mortality, with early and sustained separation of survival curves (p<0.0001).Hb 10 was associated with higher survival (76.9% vs 51.1%) and lower risk of death (HR 0.42, p=0.0003).Despite higher mortality, patients with Hb <10 were less likely to undergo durable ventricular assist device implantation (1.0% vs 2.5%, p=0.0003) or heart transplantation (1.0% vs 2.0%, p=0.009).Pooled temporary mechanical circulatory support use, defined as receipt of an intra-aortic balloon pump, Impella device, or veno-arterial extracorporeal membrane oxygenation, was similar between groups (2.52% vs 2.6%, p=0.89).Conclusions: Admission Hb <10 signifies a high-risk CS subgroup with worse survival and less use of durable advanced therapies.Admission Hb is crucial for early risk assessment and decision-making in CS.