{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:17:14Z","timestamp":1789168634494,"version":"build-2803163510"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["413635475"],"award-info":[{"award-number":["413635475"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Munich Clinician Scientist Program"},{"name":"Medical Faculty of LMU Munich"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Studies have shown a so-called off-hour effect for many different diseases, but data are scarce concerning cardiogenic shock. We therefore assessed the association of off-hour vs. on-hour intensive care unit admission with 30-day mortality in patients with cardiogenic shock.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>In total, 1720 cardiogenic shock patients (666 admitted during off-hours) from two large university hospitals in Germany were included in retrospect. An admission during off-hours was associated with increased 30-day mortality compared to an admission during on-hours [crude mortality 48% vs. 41%, HR 1.17 (1.03\u20131.33), P = 0.017]. This effect remained significant after propensity score matching (P = 0.023). Neither patients with a combined SCAI stage D and E (P = 0.088) or C (P = 0.548) nor those requiring cardiopulmonary resuscitation (P = 0.114) had a higher mortality at off-hour admission. In contrast, those without veno-arterial extracorporeal membrane oxygenation [HR 1.17 (1.00\u20131.36), P = 0.049], without acute myocardial infarction [HR 1.27 (1.02\u20131.56), P = 0.029] or a with combined SCAI stage A and B [HR 2.23 (1.08\u20134.57), P = 0.025] had an increased mortality at off-hour admission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our study showed an increased mortality in patients with cardiogenic shock admitted during off-hours, especially in those with a milder onset of disease. This stresses the importance of a thorough workup of each patient, especially at times of limited resources, the menace of underestimating the severity of cardiogenic shock, and the need for an improved 24\u00d77 available risk stratification.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuae012","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T12:50:14Z","timestamp":1706791814000},"page":"347-353","source":"Crossref","is-referenced-by-count":5,"title":["The association of off-hour vs. on-hour intensive care unit admission time with mortality in patients with cardiogenic shock: a retrospective multi-centre analysis"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3911-6144","authenticated-orcid":false,"given":"Dominik","family":"Naumann","sequence":"first","affiliation":[{"name":"Department of Medicine I, LMU University Hospital, LMU Munich , Marchioninistra\u00dfe 15, 81377 Munich , Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Medicine I, LMU University Hospital, LMU Munich , Marchioninistra\u00dfe 15, 81377 Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Gmeiner","sequence":"additional","affiliation":[{"name":"Department of Medicine I, LMU University Hospital, LMU Munich , Marchioninistra\u00dfe 15, 81377 Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enzo","family":"L\u00fcsebrink","sequence":"additional","affiliation":[{"name":"Department of Medicine I, LMU University Hospital, LMU Munich , Marchioninistra\u00dfe 15, 81377 Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt N","family":"Beer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf , Martinistra\u00dfe 52, 20251 Hamburg , Germany"},{"name":"DZHK (German Centre for Cardiovascular Research) , Hamburg\/L\u00fcbeck\/Kiel , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Grieger","sequence":"additional","affiliation":[{"name":"Department of Medicine I, LMU University Hospital, LMU Munich , Marchioninistra\u00dfe 15, 81377 Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atakan","family":"Giousouf","sequence":"additional","affiliation":[{"name":"Department of Medicine I, LMU University Hospital, LMU Munich , Marchioninistra\u00dfe 15, 81377 Munich , 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Marchioninistra\u00dfe 15, 81377 Munich , Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9830-1941","authenticated-orcid":false,"given":"Martin","family":"Orban","sequence":"additional","affiliation":[{"name":"Department of Medicine I, LMU University Hospital, LMU Munich , Marchioninistra\u00dfe 15, 81377 Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2816-6793","authenticated-orcid":false,"given":"Clemens","family":"Scherer","sequence":"additional","affiliation":[{"name":"Department of Medicine I, LMU University Hospital, LMU Munich , Marchioninistra\u00dfe 15, 81377 Munich , Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Munich Heart Alliance , Munich , 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