Journal article
Application of Cardiogenic Shock Working Group-defined Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) Staging of Cardiogenic Shock to the Medical Information Mart for Intensive Care IV (MIMIC-IV) database
Cardiovascular revascularization medicine, v 57, pp 82-90
01 Dec 2023
PMID: 37400345
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The optimal parameters for defining stages of cardiogenic shock (CS) are not yet known. The Cardiogenic Shock Working Group-defined Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) staging of CS was developed to provide simple and specific parameters for risk-stratifying patients.
The purpose of this study was to test whether the Cardiogenic Shock Working Group-defined Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) staging is associated with in-hospital mortality, using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database.
We utilized the open-access MIMIC-IV database, which includes >300,000 patients admitted between 2008 and 2019. We extracted the clinical profile of patients admitted with CS and stratified them into different SCAI stages at admission based on the CSWG criteria. We then tested the association between in-hospital mortality and parameters of hypotension, hypoperfusion, and overall CSWG-SCAI stage.
Of the 2463 patients, CS was predominantly caused by heart failure (HF; 54.7 %) or myocardial infarction (MI; 26.3 %). Mortality was 37.5 % for the total cohort, 32.7 % for patients with HF, and 40 % for patients with MI (p < 0.001). Mortality was higher among patients with mean arterial pressure < 65 mmHg, lactate >2 mmol/L, ALT >200 IU/L, pH ≤ 7.2, and more than one drug/device support at baseline. Increasing CSWG-SCAI stages at baseline and maximum CSWG-SCAI stage achieved were significantly associated with in-hospital mortality (p < 0.05).
The CSWG-SCAI stages are significantly associated with in-hospital mortality and may be used to identify hospitalized patients at risk of worsening cardiogenic shock severity.
We analyzed data from 2463 patients with cardiogenic shock using the MIMIC-IV database to investigate the relationship between the Cardiogenic Shock Working Group-defined Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) staging and in-hospital mortality. The main causes of cardiogenic shock were heart failure (54.7 %) and myocardial infarction (26.3 %). The overall mortality rate was 37.5 %, with a higher rate among patients with myocardial infarction (40 %) compared to those with heart failure (32.7 %). Mean arterial pressure < 65 mmHg, lactate >2 mmol/L, ALT >200 IU/L, and pH ≤ 7.2 were significantly associated with mortality. Increasing CSWG-SCAI stages at baseline and maximum achieved stages were strongly associated with higher mortality (p < 0.05). Therefore, the CSWG-SCAI staging system can be used to risk-stratify patients with cardiogenic shock.
•Cardiogenic shock patients with MAP <65 mm Hg, lactate >2 mmol/L, ALT >200 IU/L, pH ≤ 7.2, and needing >1 drug/device support have higher mortality.•Increasing CSWG-SCAI stages at baseline and maximum stage achieved are associated with higher in-hospital mortality.•The CSWG-SCAI classification is a clinically relevant approach to defining, staging, and risk-stratifying hospitalized CS patients.
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Details
- Title
- Application of Cardiogenic Shock Working Group-defined Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) Staging of Cardiogenic Shock to the Medical Information Mart for Intensive Care IV (MIMIC-IV) database
- Creators
- Kevin John John - Tufts Medical CenterSamuel M. Stone - Tufts Medical CenterYijing Zhang - Tufts Medical CenterBorui Li - Tufts Medical CenterSong Li - University of Washington Medical CenterJaime Hernandez-Montfort - Baylor Scott and White Health, Advanced Heart Failure Program, Temple, TX, USAManreet K. Kanwar - Allegheny Health NetworkA. Reshad Garan - Beth Israel Deaconess Medical CenterDaniel Burkhoff - Cardiovascular Research FoundationShashank S. Sinha - Alaska Heart and Vascular InstitutePaavni Sangal - Tufts Medical CenterNeil M. Harwani - Tufts Medical CenterKarol Walec - Tufts Medical CenterPeter Zazzali - Tufts Medical CenterNavin K. Kapur - Tufts Medical Center
- Publication Details
- Cardiovascular revascularization medicine, v 57, pp 82-90
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiology
- Web of Science ID
- WOS:001135672700001
- Scopus ID
- 2-s2.0-85163865587
- Other Identifier
- 991021932101804721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Physics, Multidisciplinary