Acute cardiac care & resuscitation
Sex-specific prediction of cardiogenic shock after acute coronary syndromes: the SEX-SHOCK score
Authors' conclusion
The ORBI score showed modest sex-specific performance. The novel SEX-SHOCK score provides superior performance in females and males across the entire spectrum of ACS
Study context
- Population
- Acute coronary syndromes (ACS) patients without cardiogenic shock on admission undergoing percutaneous coronary intervention (PCI)
- Participants
- 53,537 patients
- Comparison
- SEX-SHOCK score vs ORBI score, by sex
- Outcome
- Discrimination (AUC) for prediction of in-hospital cardiogenic shock, by sex
Methodological detailsmultinational, internal and external validation, regression and machine-learning models
- Multinational
- Internal and external validation
- Regression and machine-learning models
Performance
As reported in the abstract
AUC for CS prediction
| Test or model | AUC females, Swiss | AUC males, Swiss | AUC females, French | AUC males, French | AUC females | AUC males | AUC females, RICO | AUC males, RICO | AUC females, SPUM-ACS | AUC males, SPUM-ACS |
|---|---|---|---|---|---|---|---|---|---|---|
| ORBI | 0.78 [0.76-0.81] | 0.81 [0.79-0.83] | 0.77 [0.74-0.81] | 0.84 [0.81-0.86] | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract |
| SEX-SHOCK | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | 0.81 [0.78-0.83] | 0.83 [0.82-0.85] | 0.82 [0.79-0.85] | 0.88 [0.86-0.89] | 0.83 [0.77-0.90] | 0.83 [0.80-0.87] |
AUC females, Swiss
ORBI0.78 [0.76-0.81]
SEX-SHOCKNot reported in the abstract
AUC males, Swiss
ORBI0.81 [0.79-0.83]
SEX-SHOCKNot reported in the abstract
AUC females, French
ORBI0.77 [0.74-0.81]
SEX-SHOCKNot reported in the abstract
AUC males, French
ORBI0.84 [0.81-0.86]
SEX-SHOCKNot reported in the abstract
AUC females
ORBINot reported in the abstract
SEX-SHOCK0.81 [0.78-0.83]
AUC males
ORBINot reported in the abstract
SEX-SHOCK0.83 [0.82-0.85]
AUC females, RICO
ORBINot reported in the abstract
SEX-SHOCK0.82 [0.79-0.85]
AUC males, RICO
ORBINot reported in the abstract
SEX-SHOCK0.88 [0.86-0.89]
AUC females, SPUM-ACS
ORBINot reported in the abstract
SEX-SHOCK0.83 [0.77-0.90]
AUC males, SPUM-ACS
ORBINot reported in the abstract
SEX-SHOCK0.83 [0.80-0.87]
- SEX-SHOCK vs ORBI: P < 0.001 — outperformed ORBI in both sexes
- SEX-SHOCK vs ORBI: P < 0.001 — RICO validation
- SEX-SHOCK vs ORBI: P = 0.004 — SPUM-ACS validation, females
- SEX-SHOCK vs ORBI: P = 0.001 — SPUM-ACS validation, males
Further findings
ORBI discrimination, females vs males
- ORBI lower AUC in females than males, Swiss
- P = 0.048
- ORBI lower AUC in females than males, French
- P = 0.002
Original publication
Sex-specific prediction of cardiogenic shock after acute coronary syndromes: the SEX-SHOCK score. Eur Heart J. Published 1 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it