Effectiveness of the Shock Team on Short-Term Outcomes in Patients With Cardiogenic Shock ― Systematic Review and Meta-Analysis ―
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background: Recently, shock teams have been introduced to optimize cardiogenic shock (CS) care; however, their clinical benefits remain unclear. We conducted a systematic review and meta-analysis to assess whether management by a shock team improves outcomes in patients with CS. Methods and Results: This meta-analysis was conducted according to the PRISMA guidelines. Studies comparing adults with CS managed with or without a shock team were identified from the PubMed, Web of Science, and Cochrane Library databases. The primary outcome was short-term mortality (cardiac intensive care unit, in-hospital, or 30-day mortality); the secondary outcome was bleeding. Of the 7 retrospective cohort studies that met the inclusion criteria, 3 without a critical risk of bias were included in the analysis. Shock team management was significantly associated with lower short-term mortality (odds ratio [OR] 0.52; 95% confidence interval [CI] 0.32-0.85; P=0.010) and bleeding complications (OR 0.62; 95% CI 0.43-0.91; P=0.010). Sensitivity analysis using crude data also supported the mortality benefit (OR 0.68; 95% CI 0.54-0.85; P<0.010). However, no randomized trials were included, and the certainty of evidence was rated very low owing to the risk of bias and inconsistency. Conclusions: Shock team management may improve short-term outcomes in patients with CS; however, the level of evidence is very low. Further prospective studies are needed to evaluate optimal shock team composition and roles.
Source: Circulation Reports
Authors: Marina Arai, Toru Kondo, Takahiro Nakashima, Hiroyuki Hanada, Katsutaka Hashiba, Takeshi Yamamoto, Naoki Nakayama, Jin Kirigaya, Tomoko Ishizu, Yumiko Hosoya, Aya Katasako-Yabumoto, Yusuke Okazaki, Masahiro Yamamoto, Kazuo Sakamoto, Takumi Osawa, Akihito Tanaka, Kunihiro Matsuo, Junichi Yamaguchi, Toshiaki Mano, Sunao Kojima, Teruo Noguchi, Yasushi Tsujimoto, Migaku Kikuchi, Toshikazu Funazaki, Yoshio Tahara, Hiroshi Nonogi, Tetsuya Matoba
Institutions: Tohoku University, Nagoya University, Kumamoto University Hospital, Hirosaki University, Nippon Medical School Hospital, Yokohama City University Medical Center, Yokohama City University, University of Tsukuba Hospital, Sakakibara Hospital, National Cerebral and Cardiovascular Center, Steel Memorial Muroran Hospital, Kyushu University Hospital, Fukuoka Tokushukai Hospital, Tokyo Women's Medical University, Kansai Rosai Hospital, Scientific Research WorkS Peer Support Group, Dokkyo University, Dokkyo Medical University, Shizuoka University, University of Shizuoka, Kyushu University
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: diamond
OpenAlex ID: W7105530856