Disparities in the management of cardiogenic shock complicating acute myocardial infarction: a questionnaire survey in Beijing

[摘要] ObjectiveTo investigate disparities in the management of cardiogenic shock complicating acute myocardial infarction (AMI-CS) across different hospital levels in Beijing.MethodsA standardized questionnaire was electronically distributed to 61 hospitals through the Beijing Cardiovascular Internal Medicine Quality Control and Improvement Center and the Beijing Extracorporeal Life Support Quality Control and Improvement Center. A multistage sampling method was also used to survey hospitals in eight Beijing districts that were not included in these quality control networks. Hospitals were categorized as Level 1 hospitals, Level 2 hospitals, or Level 3 hospitals according to international standards and the domestic context.ResultsA total of 142 hospitals were analyzed. All participating hospitals were capable of managing cardiovascular diseases. 33.1% of hospitals did not have percutaneous coronary intervention (PCI) capability; 40.8% provided only intra-aortic balloon pump and PCI, whereas 26.0% offered temporary or durable mechanical circulatory support. Level 3 hospitals often lacked established protocols for AMI-CS management. Level 1 hospitals (59.4%) and Level 2 hospitals (56.5%) were more likely to maintain a minimum mean arterial pressure target of 65 mmHg, whereas Level 3 hospitals more commonly accepted a lower target (45.5%). Pulmonary artery catheter monitoring was infrequently used across all hospital levels. Continuous lactate monitoring also differed significantly (Level 3, 39.1% vs. Level 2, 74.6% vs. Level 1, 84.4%; overall p < 0.001). Among the 61 hospitals participating in the quality control network, only 3.6% adopted the Society for Cardiovascular Angiography and Interventions shock stage classification. Shock teams were available in 71.9% of Level 1 hospitals and 44.4% of Level 2 hospitals. Furthermore, only 31.9% of Level 3 hospitals had established referral networks.ConclusionSignificant disparities exist in the diagnosis and management of AMI-CS across different hospital levels in Beijing. There is an urgent need to enhance the understanding and management of AMI-CS, especially in Level 2 and Level 3 hospitals.

[发布日期] 2026-09-25

[关键词] Acute myocardial infarction;Cardiogenic shock;Mechanical circulatory support;Care system;Survey