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 |
Specialty: Cardiology
ICD-10: ,