METHODS AND RESULTS: We conducted a retrospective cohort study based on the Medical Information Mart for
Intensive Care III (MIMIC-III) database.
Cardiogenic shock patients were enrolled and categorized into a
norepinephrine group or a non-
norepinephrine group. Propensity score matching (PSM) was used to control for confounders. Cox proportional-hazards models and multivariable logistic regression were used to investigate the relationship between
norepinephrine treatment and mortality. A total of 927 eligible patients were included: 552 patients in the
norepinephrine group and 375 patients in the non-
norepinephrine group. After PSM, 222 cases from each group were matched using a 1:1 matching algorithm. Thirty day mortality for patients treated with
norepinephrine was significantly higher than for those in the non-
norepinephrine group (41% vs. 30%, OR 1.61, 95% CI 1.09-2.39, P = 0.017; HR 1.50, 95% CI 1.09-2.06, P = 0.013). In the multivariable analysis, there was no significant difference between
norepinephrine therapy and long-term (90 day, 180 day, or 1 year) mortality (90 day (OR 1.19, 95% CI 0.82-1.74, P = 0.363), 180 day (OR 1.17, 95% CI 0.80-1.70, P = 0.418), 1 year (OR 1.14, 95% CI 0.79-1.66, P = 0.477). Patients in the
norepinephrine group required more
mechanical ventilation (84% vs. 67%, OR 2.67, 95% CI 1.70-4.25, P < 0.001) and experienced longer ICU stays (median 7 vs. 4 days, OR 7.92, 95% CI 1.40-44.83, P = 0.020) than non-
norepinephrine group.
CONCLUSIONS: