Clinician and Algorithmic Application of the 2019 and 2022 Society of Cardiovascular Angiography and Intervention Shock Stages in the Critical Care Cardiology Trials Network Registry.
Publication/Presentation Date
1-1-2023
Abstract
BACKGROUND: Algorithmic application of the 2019 Society of Cardiovascular Angiography and Intervention (SCAI) shock stages effectively stratifies mortality risk for patients with cardiogenic shock. However, clinician assessment of SCAI staging may differ. Moreover, the implications of the 2022 SCAI criteria update remain incompletely defined.
METHODS: The Critical Care Cardiology Trials Network is a multicenter registry of cardiac intensive care units (CICUs). Between 2019 and 2021, participating centers (n=32) contributed at least a 2-month snapshot of consecutive medical CICU admissions. In-hospital mortality was assessed across 3 separate staging methods: clinician assessment, Critical Care Cardiology Trials Network algorithmic application of the 2019 SCAI criteria, and a revision of the Critical Care Cardiology Trials Network application using the 2022 SCAI criteria.
RESULTS: Of 9612 admissions, 1340 (13.9%) presented with cardiogenic shock with in-hospital mortality of 35.2%. Both clinician and algorithm-based staging using the 2019 SCAI criteria identified a stepwise gradient of mortality risk (stage C-E: 19.0% to 83.7% and 14.6% to 52.2%, respectively;
CONCLUSIONS: Both clinician and algorithm-based application of the 2019 SCAI stages identify a stepwise gradient of mortality risk, although clinician-staging may better allocate higher risk patients into advanced SCAI stages. Updated algorithmic staging using the 2022 SCAI criteria and vasoactive-inotropic score further refines risk stratification.
Volume
16
Issue
1
First Page
009714
Last Page
009714
ISSN
1941-3297
Published In/Presented At
Patel, S. M., Berg, D. D., Bohula, E. A., Baird-Zars, V. M., Barnett, C. F., Barsness, G. W., Chaudhry, S. P., Daniels, L. B., van Diepen, S., Ghafghazi, S., Goldfarb, M. J., Jentzer, J. C., Katz, J. N., Kenigsberg, B. B., Lawler, P. R., Miller, P. E., Papolos, A. I., Park, J. G., Potter, B. J., Prasad, R., … CCCTN Investigators (2023). Clinician and Algorithmic Application of the 2019 and 2022 Society of Cardiovascular Angiography and Intervention Shock Stages in the Critical Care Cardiology Trials Network Registry. Circulation. Heart failure, 16(1), e009714. https://doi.org/10.1161/CIRCHEARTFAILURE.122.009714
Disciplines
Medicine and Health Sciences
PubMedID
36458542
Department(s)
Department of Medicine
Document Type
Article