Severity Scoring System of Sleeper et al for a Patient with Acute Myocardial Infarction and Cardiogenic Shock: Stage 1 Score

Description

Sleeper et al developed several scores for evaluating a patient with acute myocardial infarction with cardiogenic shock. These can help to identify a patient who may benefit from more aggressive management. The authors are from New England Research Institutes, New York University, Auckland City Hospital, St. Paul's Hospital (Vancouver), and the University of Toronto.

Patient selection: acute myocardial infarction with cardiogenic shock

Outcome: in-hospital mortality at 30 days

The Stage 1 score is based on clinical data without invasive or imaging studies.

Parameters:

(1) anoxic brain damage

(2) shock on admission

(3) location of AMI

(4) age in years

(5) end-organ hypoperfusion

(6) history of prior CABG

(7) serum creatinine in mg/dL

(8) systolic blood pressure in mm Hg

Parameter	Finding	Points
anoxic brain damage	no	0
	yes	30
shock on admission	no	0
	yes	6
location of AMI	inferior	0
	non-inferior	3
age in years	<= 45 years	0
	46 to 50 years	2
	51 to 55 years	5
	56 to 60 years	7
	61 to 65 years	10
	66 to 70 years	12
	71 to 75 years	15
	76 to 80 years	17
	81 to 85 years	20
	86 to 90 years	22
	> 90 years	25
hypoperfusion	no	0
	yes	14
history of prior CABG	no	0
	yes	7
serum creatinine	< 1.9 mg/dL	0
	>= 1.9 mg/dL	5
systolic blood pressure	<= 55 mm Hg	12
	56 to 60	11
	61 to 65	10
	66 to 70	9
	71 to 75	8
	76 to 80	7
	81 to 85	6
	86 to 90	5
	91 to 95	4
	96 to 100	3
	101 to 105	2
	106 to 110	1
	> 110	0

total score =

= SUM(points for all 8 parameters)

Interpretation:

• minimum score: 0

• maximum score: 102

• The higher the score the greater the mortality and the greater the benefit of early revascularization.

Total Score	Category
< 24	1
24 to 29	2
30 to 36	3
37 to 42	4
43 to 47	5
48 to 102	6

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Description

Specialty

ICD-10