Cardiogenic Shock With Acute Myocardial Infarction Among Older Adults in the United States

BACKGROUND: Characteristics and outcomes associated with cardiogenic shock (CS) with acute myocardial infarction (AMI) in older patients have not been well characterized. OBJECTIVES: The purpose of this study was to investigate characteristics and outcomes of older patients admitted with CS with AMI. METHODS: We used the National Inpatient Sample database to evaluate clinical characteristics of hospitalizations, clinical outcomes, and health care utilization of hospitalizations of older patients ≥80 years with CS and AMI from 2003 to 2021. We also compared data from older patients with a reference relatively younger patient population (18-79 years). RESULTS: During the study period, 207,333 hospitalizations of older patients ≥80 years and 675,491 hospitalizations of patients 18 to 79 years were identified. Between the first 4 years of the study period (2003-2006) and the final 4-year interval of the study period (2016-2019), there was an increase in the number of hospitalizations of older patients with AMI and CS (39,220-51,640). On adjusted analysis, there were increases in the percentage of older patients undergoing treatment with percutaneous coronary intervention (19.2% to 34.1%; P < 0.001) and encounters for palliative care (2.0% to 32.4%; P < 0.001) alongside a decline in in-hospital mortality (61.4% to 49.0%; P < 0.001) over the study period. Compared to patients 18 to 79 years of age, those aged ≥80 years had greater in-hospital mortality (51.8% vs 33.0%; P < 0.001). CONCLUSIONS: From 2003 to 2021, for older patients with CS and AMI, hospitalizations increased, and mortality decreased.