Association Between Procedural Volume and Outcomes in the Use of Impella for Cardiogenic Shock
By
Yuji Nishimoto
Atsushi Kikuchi
Yukihito Sato
Tetsuya Watanabe
Takahisa Yamada
Takaharu Hayashi
Masahiro Kumada
Yohei Sotomi
Yasushi Sakata
April 10, 2026
Clinical Scorecard: Association Between Procedural Volume and Outcomes in the Use of Impella for Cardiogenic Shock
At a Glance
Category Detail
Condition Cardiogenic Shock Key Mechanisms Use of Impella device for hemodynamic support Target Population Patients with cardiogenic shock Care Setting Hospitals performing Impella procedures
Key Highlights
In-hospital mortality was 43.5% overall, with lower mortality at higher volume institutions. Significant reduction in mortality observed at institutions performing 24 or more Impella cases per year. Higher rates of device-related complications at high-volume centers likely reflect better surveillance. Guideline-Based Recommendations
Diagnosis
Assess clinical presentation and hemodynamic parameters in patients with cardiogenic shock. Management
Consider consolidating Impella use at high-volume centers to improve patient outcomes. Monitoring & Follow-up
Implement vigilant surveillance for complications such as haemolysis and acute kidney injury. Risks
Monitor for device-related complications, which may be more frequent at high-volume centers. Patient & Prescribing Data
1,390 patients with cardiogenic shock treated with Impella in Japan.
Patients at higher volume institutions had lower in-hospital and 30-day mortality rates.
Clinical Best Practices
Establish a structured multidisciplinary shock team. Develop a regional hub-and-spoke system integrating high-volume centers. Related Resources & Content
