Functional Status and Health-Related Quality of Life Among Survivors of Cardiogenic Shock

BACKGROUND Most patients with cardiogenic shock (CS) survive to hospital discharge, yet data are lacking regarding patient-centered outcomes beyond discharge, including functional status and health-related quality of life (HRQoL). OBJECTIVES This study aims to evaluate patient-centered outcomes experienced by CS survivors. METHODS A prospective cohort study enrolled survivors of Society of Coronary Angiography and Intervention Stage C or greater CS at 2 hospitals from December 2023 to August 2024. The primary outcome was functional disability at 3-month follow-up, defined as a modified Rankin Scale ≥2. Patient-reported HRQoL was measured at 3 months using the EQ-5D, which encompasses 5 health domains to generate a composite index score. RESULTS A total of 141 patients enrolled, with 118 completing 3-month follow-up (87% of eligible patients). Median age was 60; 22% were women, 28% of Black race, and 20% of Hispanic ethnicity. More than one-third (36%) received temporary mechanical circulatory support. Functional disability was common at discharge (66%) and 3 months (46%). Most commonly reported problems on the EQ-5D were pain (67%), mobility limitations (48%), and anxiety/depression (35%), and 18% reported problems with self-care. Median EQ-5D Index Score was 0.84 (Q1-Q3: 0.69-0.94), relative to a U.S. population median of 0.94 for 55-64 years of age. Functional status was inversely correlated with HRQoL at 3 months (r = -0.68; P < 0.001). CONCLUSIONS Survivors of CS experienced high rates of functional limitations through 3 months, with pain and impaired mobility particularly prevalent. Patient-reported HRQoL was below population norms and significantly associated with functional status. These findings indicate that functional impairments occur frequently after CS, and further work will be necessary to define optimal strategies to improve multidomain recovery for this population.