Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score

Auffret, V; Cottin, Y; Leurent, G; Gilard, M; Beer, JC; Zabalawi, A; Chagué, F; Filippi, E; Brunet, D; Hacot, JP; Brunel, P; Mejri, M; Lorgis, L; Rouault, G; Druelles, P; Cornily, JC; Didier, R; Bot, E; Boulanger, B; Coudert, I; Loirat, A; Bedossa, M; Boulmier, D; Maza, M; Le Guellec, M; Puri, R; Zeller, M; Le Breton, H; ORBI and RICO Working Groups

doi:10.1093/eurheartj/ehy127

Acute cardiac care & resuscitation

Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score

Eur Heart JPublished 15 Mar 2018Risk score derivation and external validation study

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Authors' conclusion

The ORBI risk score provides a readily useable and efficient tool to identify patients at high-risk of developing CS during hospitalization following STEMI

Study context

Population: STEMI patients without cardiogenic shock on admission treated by primary PCIderivation 6838

Comparison: ORBI risk score categories: low (0-7), low-to-intermediate (8-10), intermediate-to-high (11-12), high (≥13)
Outcome: In-hospital STEMI-related cardiogenic shock
Follow-up: In-hospital

Methodological detailsderivation cohort (ORBI), external validation cohort (RICO), stepwise multivariable logistic regression

Derivation cohort (ORBI)
External validation cohort (RICO)
Stepwise multivariable logistic regression

Performance

As reported in the abstract

In-hospital CS rate by risk category (derivation cohort)

Low1.3%

Low-to-intermediate6.6%

Intermediate-to-high11.7%

High31.8%

C-statistic, derivation cohort: 0.84

Further findings

In-hospital CS rate by risk category (external validation, RICO cohort)

Low3.1%

Low-to-intermediate10.6%

Intermediate-to-high18.1%

High34.1%

In-hospital cardiogenic shock (CS) rate by risk category (external validation, RICO cohort) — c-statistic, validation cohort: 0.80

In-hospital CS rate by risk category (external validation, RICO cohort)

Adequate calibration in validation cohort

Reference

Authors: Auffret V, Cottin Y, Leurent G, Gilard M, Beer JC, Zabalawi A, et al.
All 29 authors
Auffret V, Cottin Y, Leurent G, Gilard M, Beer JC, Zabalawi A, Chagué F, Filippi E, Brunet D, Hacot JP, Brunel P, Mejri M, Lorgis L, Rouault G, Druelles P, Cornily JC, Didier R, Bot E, Boulanger B, Coudert I, Loirat A, Bedossa M, Boulmier D, Maza M, Le Guellec M, Puri R, Zeller M, Le Breton H, ORBI and RICO Working Groups
Journal: European Heart Journal
Published: 15 Mar 2018
DOI: 10.1093/eurheartj/ehy127
PubMed: 29554243

Country: France
Topic: Acute cardiac care & resuscitation
Also indexed: Coronary disease & ACS

Key notes

Adequate calibration in derivation cohort
11 independent variables: age >70 years, prior stroke/TIA, cardiac arrest on admission, anterior STEMI, first medical contact-to-pPCI delay >90 min, Killip class, heart rate >90/min, SBP <125 mmHg with pulse pressure <45 mmHg, glycaemia >10 mmol/L, left main culprit lesion, post-pPCI TIMI flow grade <3

Original publication

Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score. Eur Heart J. Published 15 March 2018. doi:10.1093/eurheartj/ehy127

Read the original article ↗

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