Beer et al reported the cardiogenic shock score to identify patients at greater risk who may benefit from more aggressive management. The authors are from University Heart and Vascular Center Hamburg, Mayo Clinic and University of Birmingham.
Patient selection: cardiogenic shock
Outcome: 30-day mortality
Parameters:
(1) age in years
(2) sex
(3) acute myocardial infarction
(4) systolic blood pressure in mm Hg
(5) heart rate in beats per minute
(6) arterial pH
(7) serum lactate in mmol/L
(8) blood glucose in mg/dL
(9) CPR
|
Parameter |
Finding |
Points |
|
age in years |
<= 60 years |
0 |
|
|
61 to 70 years |
2 |
|
|
71 to 80 years |
3 |
|
|
> 80 years |
4 |
|
sex |
male |
0 |
|
|
female |
1 |
|
acute myocardial infarction |
no |
1 |
|
|
yes |
0 |
|
systolic blood pressure |
>= 90 mm Hg |
0 |
|
|
< 90 mm Hg |
1 |
|
heart rate |
< 100 beats per minute |
1 |
|
|
>= 100 beats per minute |
0 |
|
arterial pH |
> 7.35 |
0 |
|
|
7.0 to 7.35 |
1 |
|
|
< 7.0 |
2 |
|
serum lactate |
< 4 mmol/L |
0 |
|
|
4 to 8 mmol/L |
1 |
|
|
> 8 mmol/L |
4 |
|
blood glucose |
< 200 mg/dL |
1 |
|
|
>= 200 mg/dL |
0 |
|
CPR |
none |
0 |
|
|
CPR < 30 minutes |
0 |
|
|
CPR >= 30 minutes |
2 |
|
|
refractory arrest |
3 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• The higher the score the greater the 30-day mortality.
|
Total Score |
30-Day Mortality in Percent |
|
0 |
13 |
|
1 |
17 |
|
2 |
22 |
|
3 |
26 |
|
4 |
33 |
|
5 |
39 |
|
6 |
47 |
|
7 |
57 |
|
8 |
66 |
|
9 |
75 |
|
10 |
82 |
|
11 |
90 |
|
12 |
96 |
|
13 |
98 |
|
14+ |
100 |
Performance:
• The area under the ROC curve is 0.74.
Specialty: Pulmonology, Critical Care
