Acute cardiac care & resuscitation
Value of APACHE II, Sequential Organ Failure Assessment (SOFA) and CardShock Scoring as Predictive Tools for Cardiogenic Shock: A Single-Centre Pilot Study
Authors' conclusion
APACHE II and SOFA could be used for the risk stratification of patients with CS admitted to the ICCU. CardShock proved to be a more appropriate tool for assessing short-term prognosis in patients with CS of all aetiologies
Study context
- Population
- Consecutive patients with cardiogenic shock admitted to the intensive cardiac care unit, May 2016–December 201732 ischaemic, 31 non-ischaemic
- Participants
- 63 patients
- Exposure
- APACHE II vs SOFA vs CardShock scores for mortality prediction
- Outcome
- Prediction of in-hospital, 30-day and 3-year mortality
Methodological detailssingle-centre, pilot
- Single-centre
- Pilot
Main finding
As reported in the abstract
Prediction of mortality
| Group | AUC in-hospital mortality (cut-off 5 points) | AUC 30-day mortality (cut-off 4 points) |
|---|---|---|
| CardShock | 0.70 (95% CI 0.59-0.81; P = 0.001) | 0.71 (95% CI 0.60-0.82; P < 0.001) |
CardShock
AUC in-hospital mortality (cut-off 5 points)0.70 (95% CI 0.59-0.81; P = 0.001)
AUC 30-day mortality (cut-off 4 points)0.71 (95% CI 0.60-0.82; P < 0.001)
- APACHE II and SOFA higher in those who died at 30 days
- P = 0.043 and P = 0.045
- CardShock higher in those who died in hospital
- P = 0.007
- CardShock higher in those who died within 30 days
- P = 0.004
Observational data: associations, not effects.
Further findings
Baseline median scores
Mortality (whole cohort)
- In-hospital mortality
- 39.7%
- 30-day mortality
- 41.3%
- 3-year mortality
- 77.8%
Bayesian Weibull model: short-term risk
- Impact of APACHE II and SOFA on life expectancy non-significant at ≈32 days
- Impact of CardShock on life expectancy non-significant at 33 days
Prognostic factors (Bayesian logistic regression, 94% highest density interval (HDI))
- Unfavourable prognosis: invasive or non-invasive ventilation, higher heart rate, less negative fluid balance
- Survival associated with pre-CS class, higher GFR and higher platelet count
Original publication
Value of APACHE II, SOFA and CardShock Scoring as Predictive Tools for Cardiogenic Shock: A Single-Centre Pilot Study. ESC Heart Fail. Published 13 August 2024. doi:10.
Summarised from the published abstract; every number is checked against it