Procedural volume and outcomes of Impella support in cardiogenic shock
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By
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Yuji Nishimoto
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Atsushi Kikuchi
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Yukihito Sato
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Tetsuya Watanabe
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Takahisa Yamada
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Takaharu Hayashi
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Masahiro Kumada
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Yohei Sotomi
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Yasushi Sakata
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April 10, 2026
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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.
References
