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Cardiogenic Shock Classification to Predict Mortality in the Cardiac Intensive Care Unit
Open accessAbstract
BACKGROUND A new 5-stage cardiogenic shock (CS) classification scheme was recently proposed by the Society for Cardiovascular Angiography and Intervention (SCAI) for the purpose of risk stratification. OBJECTIVES This study sought to apply the SCAI shock classification in a cardiac intensive care unit (CICU) population. METHODS The study retrospectively analyzed Mayo Clinic CICU patients admitted between 2007 and 2015. SCAI CS stages A through E were classified retrospectively using CICU admission data based on the presence of hypotension or tachycardia, hypoperfusion, deterioration, and refractory shock. Hospital mortality in each SCAI shock stage was stratified by cardiac arrest (CA). RESULTS Among the 10,004 unique patients, 43.1% had acute coronary syndrome, 46.1% had heart failure, and 12.1% had CA. The proportion of patients in SCAI CS stages A through E was 46.0%, 30.0%, 15.7%, 7.3%, and 1.0% and unadjusted hospital mortality in these stages was 3.0%, 7.1%, 12.4%, 40.4%, and 67.0% (p < 0.001), respectively. After multivariable adjustment, each higher SCAI shock stage was associated with increased hospital mortality (adjusted odds ratio: 1.53 to 6.80; all p < 0.001) compared with SCAI shock stage A, as was CA (adjusted odds ratio: 3.99; 95% confidence interval: 3.27 to 4.86; p < 0.001). Results were consistent in the subset of patients with acute coronary syndrome or heart failure. CONCLUSIONS When assessed at the time of CICU admission, the SCAI CS classification, including presence or absence of CA, provided robust hospital mortality risk stratification. This classification system could be implemented as a clinical and research tool to identify, communicate, and predict the risk of death in patients with, and at risk for, CS.
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Early Revascularization in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Hochman, J. S., Sleeper, L. A., Webb, J. G., Sanborn, T. A., White, H. D., Talley, J. D., Buller, C. E., Jacobs, A. K., Slater, J. N., Col, J., et al. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908263410901 · Cited by 3,131
Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock
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Self-citationPCI strategies in patients with acute myocardial infarction and cardiogenic shock
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Self-citationINTERMACS Profiles of Advanced Heart Failure: The Current Picture
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Clinical Picture and Risk Prediction of Short-Term Mortality in Cardiogenic Shock
Harjola, V.-P., Lassus, J., Sionis, A., Køber, L., Tarvasmäki, T., Spinar, J., Parissis, J., Banaszewski, M., Silva-Cardoso, J., Carubelli, V., et al. (2015) · European Journal of Heart Failure · doi:10.1002/ejhf.260 · Cited by 790
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Self-citationKolte, D., Khera, S., Aronow, W. S., Mujib, M., Palaniswamy, C., Sule, S., Jain, D., Gotsis, W., Ahmed, A., Frishman, W. H., et al. (2014) · Journal of the American Heart Association · doi:10.1161/jaha.113.000590 · Cited by 628
National Trends in the Utilization of Short-Term Mechanical Circulatory Support
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Cited by
Rao, S. V., O’Donoghue, M. L., Ruel, M., Rab, T., Tamis-Holland, J. E., Alexander, J. H., Baber, U., Baker, H., Cohen, M. G., Cruz-Ruiz, M., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001309 · Cited by 625
Self-citationThayer, K. L., Zweck, E., Ayouty, M., Garan, A. R., Hernandez-Montfort, J., Mahr, C., Morine, K. J., Newman, S., Jorde, L., Haywood, J. L., et al. (2020) · Circulation: Heart Failure · doi:10.1161/circheartfailure.120.007099 · Cited by 319
Metadata
- Authors
- Jentzer, J. C., van Diepen, S., Barsness, G. W., Henry, T. D., Menon, V., Rihal, C. S., Naidu, S. S., & Baran, D. A.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2019-10
- Volume
- 74
- Issue
- 17
- Pages
- 2117-2128
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2974296394
- Cited by
- 554
- References
- 25
- FWCI
- 19.90
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Jentzer, J. C., van Diepen, S., Barsness, G. W., Henry, T. D., Menon, V., Rihal, C. S., Naidu, S. S., & Baran, D. A. (2019). Cardiogenic Shock Classification to Predict Mortality in the Cardiac Intensive Care Unit. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2019.07.077
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