Harjola et al reported the CardShock score for evaluating a patient with cardiogenic shock. This score can help to stratify the short-term mortality risk. The authors are from multiple institutions in Europe.
Patient selection: cardiogenic shock
Parameters:
(1) age in years
(2) confusion at presentation
(3) previous myocardial infarction or CABG
(4) etiology
(5) left ventricular ejection fraction in percent
(6) blood lactate in mmol/L
(7) eGFR by CKD-EPI
Parameter
Finding
Points
age in years
<= 75 years
0
> 75 years
1
confusion at presentation
no
0
yes
1
previous AMI or CABG
no
0
yes
1
etiology
acute coronary syndrome
1
other
0
LVEF in percent
>= 40%
0
< 40%
1
blood lactate
< 2 mmol/L
0
2-4 mmol/L
1
> 4 mmol/L
2
eGFR
> 60 mL per min per 1.73 square meter
0
30-60
1
< 30
2
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the worse the prognosis.
Total Score
Risk Group
In-Hospital Mortality
0 to 3
low
8.7%
4 or 5
intermediate
36%
6 to 9
high
> 77%
Score
In-Hospital Mortality
0 or 1
0%
2
9%
3
11.5%
4
32%
5
38%
6
70%
7
79%
8 or 9
100%
from Figure 3
Performance:
• The area under the ROC curve is 0.85.
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