{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:59:20Z","timestamp":1792677560780,"version":"4.5.0"},"reference-count":0,"publisher":"SEMES (Sociedad Espanola de Medicina de Urgencias y Emergencias)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Emergencias"],"published-print":{"date-parts":[[2024,11,19]]},"abstract":"<jats:p>Objetivos. Describir las caracter\u00edsticas de los pacientes diagnosticados de insuficiencia cardiaca aguda (ICA) en urgencias y que desarrollaron shock cardiog\u00e9nico (SC) no asociado a un s\u00edndrome coronario agudo con elevaci\u00f3n del segmento ST (SCACEST). M\u00e9todo. Se incluyeron pacientes diagnosticados de ICA en 23 servicios de urgencias (SU) espa\u00f1oles durante periodos intermitentes entre 2009 y 2019, que cumpl\u00edan criterios de SC. Se describen las caracter\u00edsticas cl\u00ednicas basales relacionadas con la descompensaci\u00f3n y con el desarrollo de SC, as\u00ed como la mortalidad en los primeros 30 d\u00edas. Resultados: Se diagnosticaron 15.920 casos de ICA, 179 con SC [prevalencia = 1,1% (0,2%-3,2%), edad mediana: 82 a\u00f1os, 53% mujeres]. Las causas m\u00e1s frecuentes de cardiopat\u00eda eran valvulopat\u00eda y enfermedad coronaria, el 76% ten\u00eda episodios previos de ICA y m\u00e1s del 40% presentaba situaci\u00f3n funcional y respiratoria basal gravemente deterioradasEn el 75% de los pacientes se inici\u00f3 el tratamiento del SC en el SU, el 22% present\u00f3 SC refractario, con tratamiento paliativo en el 13%. Los pacientes con SC ten\u00edan presi\u00f3n arterial media m\u00e1s baja, peor clase NYHA basal, m\u00e1s frecuencia de valvulopat\u00eda, s\u00edndrome coronario agudo sin elevaci\u00f3n del segmento ST (SCASEST), traslado a urgencias con una unidad de soporte vital avanzado e hiponatremia grave, y con menos frecuencia de edemas en extremidades inferiores, comparado con los pacientes sin SC. La mortalidad a los 30 d\u00edas fue del 38,5% (31,3-45,7), 21 de ellos (12% de los SC) durante su estancia en el SU, y se relacion\u00f3 con la edad $ 80 a\u00f1os (HR ajustada 1,977, IC 95%: 1,169- 3,343), hipertensi\u00f3n arterial (2,123, 1,035-4,352), anemia (2,262, 1,029-4,970), signos de bajo gasto cardiaco (1,877, 1,150-3,062) y tasa de filtrado glomerular &lt; 30 mL\/min\/1,73 m2 (1,758, 1,051-2,939). Conclusiones. El SC, fuera del contexto de SCACEST, es una forma cl\u00ednica poco frecuente en pacientes diagnosticados de ICA en los SU y se relaciona con una peor clase funcional previa, mayor frecuencia de valvulopat\u00eda, hip<\/jats:p>","DOI":"10.55633\/s3me\/105.2024","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T13:07:26Z","timestamp":1732021646000},"source":"Crossref","is-referenced-by-count":2,"title":["Epidemiologic and clinical characteristics and course of acute heart failure and cardiogenic shock diagnosed in emergency departments"],"prefix":"10.55633","author":[{"given":"Bego\u00f1a","family":"Espinosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Llorens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Jacob","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V\u00edctor","family":"Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aitor","family":"Alqu\u00e9zar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Dieste Ballar\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Pilar","family":"L\u00f3pez-D\u00edez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Manuel","family":"Garrido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"del Amo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Tost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Paz Arias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Llu\u00eds","family":"Llauger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Herrero-Puente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Gorlicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Masip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d2scar","family":"Mir\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33356","published-online":{"date-parts":[[2024,11,19]]},"container-title":["Emergencias"],"original-title":["Caracter\u00edsticas epidemiol\u00f3gicas, cl\u00ednicas y evolutivas de los pacientes con insuficiencia cardiaca aguda y shock cardiog\u00e9nico diagnosticados en urgencias"],"deposited":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T13:07:27Z","timestamp":1732021647000},"score":1,"resource":{"primary":{"URL":"https:\/\/revistaemergencias.org\/articulo\/caracteristicas-epidemiologicas-clinicas-y-evolutivas-de-los-pacientes-con-insuficiencia-cardiaca-aguda-y-shock-cardiogenico-diagnosticados-en-urgencias\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,19]]},"references-count":0,"URL":"https:\/\/doi.org\/10.55633\/s3me\/105.2024","relation":{},"ISSN":["1137-6821","2386-5857"],"issn-type":[{"value":"1137-6821","type":"print"},{"value":"2386-5857","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,19]]}}}