Acute cardiac care & resuscitation
Clinician and Algorithmic Application of the 2019 and 2022 Society of Cardiovascular Angiography and Intervention Shock Stages in the Critical Care Cardiology Trials Network Registry
Authors' conclusion
Both clinician and algorithm-based application of the 2019 SCAI stages identify a stepwise gradient of mortality risk, although clinician-staging may better allocate higher risk patients into advanced SCAI stages. Updated algorithmic staging using the 2022 SCAI criteria and vasoactive-inotropic score further refines risk stratification.
Study context
- Population
- Consecutive medical cardiac ICU admissions with cardiogenic shock, 32 centres, 2019–20211,340 (13.9%) with cardiogenic shock
- Participants
- 9,612 admissions
- Exposure
- Clinician vs 2019 algorithm vs 2022 algorithm
- Outcome
- In-hospital mortality across SCAI shock stages
Methodological detailsmulticenter
- Multicenter
Main finding
As reported in the abstract
In-hospital mortality, SCAI stage C-E
| Outcome | Clinician | 2019 algorithm | 2022 algorithm | |
|---|---|---|---|---|
| In-hospital mortality, SCAI stage C-E | 19.0% to 83.7% | 14.6% to 52.2% | 21.9% to 70.5% | |
| Stage D | 49.9% | 29.3% | Not reported in the abstract | 2022 algorithm: not reported in the abstract |
| Stage E | 83.7% | 52.2% | Not reported in the abstract | 2022 algorithm: not reported in the abstract |
- Stepwise mortality gradient, clinician staging
- P for trend < 0.001
- Stepwise mortality gradient, 2019 algorithm
- P for trend < 0.001
- Stepwise mortality gradient, 2022 algorithm
- P for trend < 0.001
Observational data: associations, not effects.
Original publication
Clinician and Algorithmic Application of the 2019 and 2022 Society of Cardiovascular Angiography and Intervention Shock Stages in the Critical Care Cardiology Trials Network Registry. Circ Heart Fail. Published 2 December 2022. doi:10.
Summarised from the published abstract; every number is checked against it