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.
Specialty: Critical Care