Medical Student New Milford, New Jersey, United States
Disclosure(s):
Nicole Easo, BA: No financial relationships to disclose
Background: Multidisciplinary shock team partnerships with community hospitals can lead to earlier recognition of CS and deployment of therapies. As the Penn Medicine CS Team, we reviewed our data to demonstrate improved outcomes compared to published outcomes in the literature and improved referral patterns from community hospitals.
Methods: We collected data on our shock team since its inception from 11/2019-12/2025. These data include review of patient profiles, tMCS use, strategies for programmatic improvement, and outcomes of our shock patients, including overall disposition as well as disposition after tMCS.
Outcome: From 11/25/2019-12/22/2025, our team had a total of 1035 shock calls. 6% were internal referrals while 94% were calls from external OSH referrals. 774 (75%) patients were accepted by our shock team (“Go”) and included in our analysis. 261 (25%) did not meet criteria (“No Go”), most commonly because they were not candidates for advanced support. Of accepted OSH patients, 245 (32%) had tMCS present on arrival with the intra-aortic balloon pump (IABP) as the most common device present on arrival. 354 (46%) utilized tMCS (VA ECMO, Impella 5.5) during hospitalization. In patients requiring tMCS, 226 (64%) remain alive, 222 (63%) of whom have since been discharged. Regarding our 774 accepted patients, 577 (75%) remain alive, of whom 555 (72%) were discharged. The PMCST reviews transfers monthly and targets outreach based on territories with lagging referrals (Figure 1). For example, referrals from Chester County Hospital, one of our community hospitals, demonstrated an increased proportion of patients with less severe SCAI classifications in comparison to that prior to our outreach initiatives (Class C: 33% in 2022 vs 40% in 2025) while classes of higher severity were seen less overtime (Class D: 44% vs 42%, Class E: 19% vs 14%) (Figure 2).
Conclusion: Our results show that a multidisciplinary shock team can improve community partnerships with excellent outcomes. With targeted outreach, referral patterns have increased from areas which were previously lagging alongside an increase in transfer of patients in earlier stages of cardiogenic shock.
