Acute cardiac care & resuscitationCohort study
Serial Shock Severity Assessment Within 72 Hours After Diagnosis
- Registry-based cohort study
- multicentre
Authors' conclusion
Most patients with CS changed SCAI stages within 24 hours from CS diagnosis. Stage B patients were at high risk of worsening shock severity by 24 hours, associated with excess mortality.
Study context
- Population
- Patients with cardiogenic shock complicating acute MI (MI-CS) or HF-related cardiogenic shock (CS) (HF-CS), CSWG registry57% HF-CS
- Participants
- 3,268 patients
- Exposure
- Stage B vs Stage C vs Stage D vs Stage E
- Stage Bn = 593
- Stage Cn = 528
- Stage Dn = 1,659
- Stage En = 488
- Outcome
- Serial changes in CSWG-SCAI stages and outcomes
- Follow-up
- CS diagnosis and 24, 48 and 72 hours
Main finding
As reported in the abstract
SCAI stage change by 24 hours · 24 hours
Stages B and C worsened
>50%
Stage D stayed at stage D
86%
Stage E improved to stage D
54%
Stage E stayed at stage E
36%
Observational data: associations, not effects.
Further findings
Unadjusted mortality by SCAI stage change within 24 hours
- Any SCAI stage worsening
- 44.6%
- Any SCAI stage improving
- 34.2%
- Presenting in or progressing to stage E by 24 hours had the worst prognosis
- unadjusted
Lactate
- Survivors had lower lactate than nonsurvivors
Original publication
Serial Shock Severity Assessment Within 72 Hours After Diagnosis. J Am Coll Cardiol. Published 1 August 2024. doi:10.1016/j.jacc.2024.04.069
Summarised from the published abstract; every number is checked against it