Abstract 4113420: Assessing the Clinical Impact of Cardiac Intensivists in Cardiac Intensive Care Units.: Results from the RESCUE registry

Background: Presence of dedicated intensive care unit physicians is associated with reduced intensive care unit mortality. However, there is limited information regarding the impact of cardiac intensivists in cardiac intensive care units. Research Questions: What is the role of cardiac intensivists in influencing clinical outcomes for adult patients admitted to cardiac intensive care units? Aims: To investigate the association between cardiac intensivist-directed care and clinical outcomes in adult patients admitted to cardiac intensive care units. Methods: This retrospective study used data from the SMART-RESCUE registry, which is a multicenter, retrospective, and prospective registry of patients presenting with cardiogenic shock. The study involved 1,247 patients enrolled from January 2014 to December 2018 at 12 tertiary centers in Korea. These patients, who were suffering from cardiogenic shock, were divided into two groups depending on whether their care involved a cardiac intensivist. Results: The study found that the all-cause mortality rate was 33.6%. The in-hospital mortality rate was significantly lower in the group managed by cardiac intensivists (25.4%) compared to the group without (40.1%). Similarly, cardiac death rates were lower in the cardiac intensivist group (20.5%) than in the non-cardiac intensivist group (35.4%). In patients undergoing extracorporeal membrane oxygenation, mortality at centers with cardiac intensivists was 38.0%, compared to 62.2% at centers without. The use of dopamine was lower and norepinephrine use was higher and the vasoactive-inotropic score was lower in the cardiac intensivist group. Conclusion: Cardiac intensivist involvement in patient care within cardiac intensive care units was associated with a reduction in in-hospital mortality and administration of vasopressors and inotropes according to cardiogenic shock guidelines, indicating a beneficial effect on clinical outcomes.