This retrospective National Inpatient Sample study examined adult obstructive hypertrophic cardiomyopathy hospitalizations complicated by cardiogenic shock during 2016–2022. Of 4,610 hospitalizations, 280 (6.1%) received temporary mechanical circulatory support, most commonly VA-ECMO. In-hospital mortality was 42.9% with support versus 22.0% without support; the adjusted association remained significant (adjusted odds ratio 2.88, 95% confidence interval 1.46–5.69). Support was also associated with higher hospital charges, but not significantly longer stays. The authors interpreted these associations as likely reflecting greater illness severity among patients selected for support rather than treatment-related harm.
Temporary MCS use identified a high-mortality subgroup of obstructive HCM hospitalizations with cardiogenic shock. These observational findings do not establish that MCS caused harm or determine its comparative benefit.
Study limitation: Selection of more severely ill patients for MCS limits causal interpretation despite multivariable adjustment.
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