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INTRODUCTION: Cardiogenic shock (CS) is a critical condition and the leading cause of mortality after coronary artery bypass grafting (CABG). To define the risk factors for CS in patients who undergo CABG and create a risk-predictive model is crucial. METHODS: In this observational study, we retrospectively evaluated consecutive patients who underwent CABG between January 2018 and October 2022 at Beijing Anzhen Hospital. A total of 496 patients were enrolled and categorized into the training (396 cases) and internal test (100 cases) sets. The variables significantly associated with mortality (p < 0.05) were analyzed using logistic regression analyses. RESULTS: The E/A ratio at admission, postoperative brain natriuretic peptide, postoperative arterial lactate, two or more arrhythmias at the same time after CABG, and carotid artery stenosis at admission were identified as independent prognostic factors for in-hospital mortality after multivariate logistic regression analysis. The CS after CABG score (ACCS) was established and three classes of ACCS, named classes I (ACCS, <20), II (ACCS, 20-30), and III (ACCS, >30), made up the risk model. The ACCS showed better discrimination with an AUROC of 0.937 (95% confidence interval, 0.982-0.892) and calibration with the Hosmer-Lemeshow test (X2 = 5.854 with 8 df; p = 0.664). In addition, tenfold cross-validation demonstrated that the mean misdiagnosis rate was 5.56% and the lowest misdiagnosis rate was 6.38%. CONCLUSION: The ACCS score represents a risk-predictive model for in-hospital mortality of patients with CS after CABG in acute care settings. Patients identified as class III may have a worse prognosis.
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All-solid-state lithium batteries (ASSLBs) paired with an argyrodite sulfide solid electrolyte have become a candidate to take the world by storm for achieving high energy and safety. However, the undesirable interface design between a sulfide solid electrolyte and cathode is difficult to address its scalability production challenge. Particularly, the inferior interfacial contact between a sulfide solid electrolyte and cathode is an intractable obstacle for the large-scale commercial application of ASSLBs. Herein, an elaborately designed conformally in situ integration of a sulfide solid electrolyte onto a Ni-rich oxide cathode is proposed to overcome this issue through a facile tape casting method. In this unique integrated electrode structure, the sulfide solid electrolyte intimately makes contact with the Ni-rich oxide cathode, which significantly strengthens the solid-solid interfacial compatibility, as well as decreases the interfacial reaction resistances, thereby enabling rapid Li+ transportation and a stable interfacial structure. As a result, ASSLBs consisting of a sulfide solid electrolyte-integrated Ni-rich oxide cathode and Li anode exhibit high discharge capacity, excellent cyclic stability, and remarkable rate performance, which are superior to the cells with segregated structures composed of a Ni-rich oxide cathode, sulfide solid electrolyte, and Li anode. The features clearly indicate that the advanced interfacial contact between the cathode and solid electrolyte is responsible for ASSLBs with low polarization and fast reaction kinetics. Therefore, this work provides a rational proof-of-concept fabrication protocol for the reliable interfacial structure design of high-performance ASSLBs.
