Cardiogenic Shock Classification and Associated Mortality Risk.
Publication/Presentation Date
5-1-2023
Abstract
The Society for Cardiovascular Angiography and Interventions (SCAI) Shock Classification was developed to create standardized language describing the severity of cardiogenic shock (CS). The purposes of this review were to evaluate short-term and long-term mortality rates at each SCAI shock stage for patients with or at risk for CS, which has not been studied previously, and to propose using the SCAI Shock Classification to develop algorithms for clinical status monitoring. A detailed literature search was conducted for articles published from 2019 through 2022 in which the SCAI shock stages were used to assess the mortality risk. In total, 30 articles were reviewed. The SCAI Shock Classification at hospital admission revealed a consistent and reproducible graded association between shock severity and mortality risk. Furthermore, shock severity correlated incrementally with mortality risk even after patients were stratified for diagnosis, treatment modalities, risk modifiers, shock phenotype, and underlying cause. The SCAI Shock Classification system can be used to evaluate mortality across populations of patients with or at risk for CS including those with different causes, shock phenotypes, and comorbid conditions. We propose an algorithm that uses clinical parameters incorporating the SCAI Shock Classification into the electronic health record to continually reassess and reclassify the presence and severity of CS across time throughout hospitalization. The algorithm has the potential to alert the care team and a CS team, leading to earlier recognition and stabilization of the patient, and may facilitate the use of treatment algorithms and prevent CS deterioration, leading to improved outcomes.
Volume
98
Issue
5
First Page
771
Last Page
783
ISSN
1942-5546
Published In/Presented At
Hill, K. L., Rustin, M. A., Asche, M. A., Bennett, C. E., Patel, P. C., & Jentzer, J. C. (2023). Cardiogenic Shock Classification and Associated Mortality Risk. Mayo Clinic proceedings, 98(5), 771–783. https://doi.org/10.1016/j.mayocp.2022.12.007
Disciplines
Medicine and Health Sciences
PubMedID
37028976
Department(s)
Department of Medicine, Cardiology Division
Document Type
Article