Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Aims: Treatment with mechanical circulatory support (MCS) has been proposed to mitigate mortality in cardiogenic shock (CS). However, there is a lack of data on MCS programs implementation and the effect of the learning curve on its outcomes in limited resources countries such as Brazil.
Methods: Prospective cohort of patients with CS admitted in four tertiary-care centers treated with Impella CP or veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Clinical outcomes were peri-procedural complications, short-term mortality rate, and the centers' learning curve. The cohort was divided into two periods: from April 2017 to July 2018 ( = 24), and from August 2018 to December 2020 ( = 25).
Results: The study enrolled 49 patients [age 59 (43-63) years; 34 (70%) males]. The most common causes for CS were acute myocardial infarction in 22 (45%) and acute decompensation of chronic heart failure in 10 (20%). VA-ECMO was employed in 35 (71%) and Impella CP in 14 (29%) of patients. Overall complications occurred in 37 (76%) of patients, where major bleeding in 19 (38%) was the most common. The overall mortality rate was 61%, but it was lower in the second period (40%) in comparison to the first period (83%), = 0.002. The learning curve analysis showed a decrease in the mortality rate after 40 consecutive cases.
Conclusions: Implementation of a temporary MCS program for refractory CS in a limited resource country is feasible. The learning curve effect might have played a role on survival rate since high morbimortality has decreased within time reaching optimal results by the end of the study.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/03913988211070841 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Dealing with manuscript rejections in academic medicine: It takes two hands to clap.
J R Coll Physicians Edinb
September 2025
Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore, Singapore.
Academic publishing is increasingly prevalent in clinical training and practice, as part of the burgeoning field of academic medicine, where physicians are expected not only to perform their conventional clinical duties and responsibilities, but also increasingly have to engage in various forms of scholarly activities to contribute to evidence-based practice, as part of their key performance indicators. However, for physicians who are not trained as academics or scientists, the learning curve for scholarly endeavours can be steep and fraught with setbacks and rejections. Therefore, in this editorial article, we offer our perspectives as residents-in-training on the roles of both clinician-authors and journal editorial/peer review teams in facilitating healthy cognitive-emotional processing of unfavourable manuscript decisions in academic medicine.
View Article and Find Full Text PDFAI-driven and Traditional Radiomic Model for Predicting Muscle Invasion in Bladder Cancer via Multi-parametric Imaging: A Systematic Review and Meta-analysis.
Acad Radiol
September 2025
Department of Urology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China (H.S., Q.W., S.F., H.W.). Electronic address:
Rationale And Objectives: This study systematically evaluates the diagnostic performance of artificial intelligence (AI)-driven and conventional radiomics models in detecting muscle-invasive bladder cancer (MIBC) through meta-analytical approaches. Furthermore, it investigates their potential synergistic value with the Vesical Imaging-Reporting and Data System (VI-RADS) and assesses clinical translation prospects.
Methods: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Beyond the Learning Curve: How Operator Experience Affects Pulsed-Field Ablation Outcomes.
Heart Rhythm
September 2025
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address:
Background: The learning curve for pulmonary vein isolation (PVI) using "single-shot" pulsed-field ablation (PFA) is thought to be short. 3D electro-anatomical mapping (3D-EAM) might provide adjunctive information to shorten the learning curve and improve lesion durability.
Objective: To analyze procedural performance markers over time for PVI using PFA and 3D-EAM.
A Multi-Task Deep Learning Pipeline Integrating Vessel Segmentation and Radiomics for Multiclass Retinal Disease Classification.
Photodiagnosis Photodyn Ther
September 2025
Department of Ophthalmology, People's Hospital of Feng Jie, Chongqing, 404600, China. Electronic address:
Objective: This study aims to develop a robust, multi-task deep learning framework that integrates vessel segmentation and radiomic analysis for the automated classification of four retinal conditions- diabetic retinopathy (DR), hypertensive retinopathy (HR), papilledema, and normal fundus-using fundus images.
Materials: AND.
Methods: A total of 2,165 patients from eight medical centers were enrolled.
End-to-end deep learning model with multi-channel and attention mechanisms for multi-class diagnosis in CT-T staging of advanced gastric cancer.
Eur J Radiol
September 2025
Department of Radiology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, Jiangsu 212002, China. Electronic address:
Background: Homogeneous AI assessment is required for CT-T staging of gastric cancer.
Purpose: To construct an End-to-End CT-based Deep Learning (DL) model for tumor T-staging in advanced gastric cancer.
Materials And Methods: A retrospective study was conducted on 460 cases of presurgical CT patients with advanced gastric cancer between 2011 and 2024.