Journal article
Serial Shock Severity Assessment Within 72 Hours After Diagnosis A Cardiogenic Shock Working Group Report
Journal of the American College of Cardiology, v 84(11), pp 978-990
01 Aug 2024
PMID: 39217545
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND The Cardiogenic Shock Working Group-modified Society for Cardiovascular Angiography and Interventions (CSWG-SCAI) staging was developed to risk stratify cardiogenic shock (CS) severity. Data showing progressive changes in SCAI stages and outcomes are limited. OBJECTIVES We investigated serial changes in CSWG-SCAI stages and outcomes of patients presenting with cardiogenic shock complicating acute myocardial infarction (MI-CS) and heart failure-related CS (HF-CS). METHODS The multicenter CSWG registry was queried. CSWG-SCAI stages were computed at CS diagnosis and 24, 48, and 72 hours. RESULTS A total of 3,268 patients (57% HF-CS; 27% MI-CS) were included. At CS diagnosis, CSWG-SCAI stage breakdown was 593 (18.1%) stage B, 528 (16.2%) stage C, 1,659 (50.8%) stage D, and 488 (14.9%) noncardiac arrest stage E. At 24 hours, >50% of stages B and C patients worsened, but 86% of stage D patients stayed at stage D. Among stage E patients, 54% improved to stage D and 36% stayed at stage E by 24 hours. Minimal SCAI stage changes occurred beyond 24 hours. SCAI stage trajectories were similar between MI-CS and HF-CS groups. Within 24 hours, unadjusted mortality rates of patients with any SCAI stage worsening or improving were 44.6% and 34.2%, respectively. Patients who presented in or progressed to stage E by 24 hours had the worst prognosis. Survivors had lower lactate than nonsurvivors. CONCLUSIONS 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. Early CS recognition and serial assessment may improve risk stratification.
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Details
- Title
- Serial Shock Severity Assessment Within 72 Hours After Diagnosis A Cardiogenic Shock Working Group Report
- Creators
- Van-Khue Ton - Massachusetts Gen Hosp, Corrigan Minehan Heart Ctr, Boston, MA USASong Li - College Station Medical CenterKevin John - Tufts Medical CenterBorui Li - Tufts Medical CenterElric Zweck - Heinrich Heine University DüsseldorfManreet K. Kanwar - Allegheny Health NetworkShashank S. Sinha - Inova Fairfax HospitalJaime Hernandez-Montfort - Baylor Scott & White HealthA. Reshad Garan - Beth Israel Deaconess Medical CenterRachel Goodman - Tufts Medical CenterAnthony Faugno - Tufts Medical CenterMaryjane Farr - The University of Texas Southwestern Medical CenterShelley Hall - Baylor University Medical CenterRachna Kataria - LifespanMaya Guglin - Indiana University – Purdue University IndianapolisEsther Vorovich - Cardiovascular Institute of the SouthMohit Pahuja - University of Oklahoma Health Sciences CenterSaraschandra Vallabhajosyula - Brown UniversitySandeep Nathan - University of ChicagoJacob Abraham - Hope Heart InstituteNeil M. Harwani - Tufts Medical CenterGavin W. Hickey - University of Pittsburgh Medical CenterAndrew D. Schwartzman - Maine Medical CenterWissam Khalife - The University of Texas Medical Branch at GalvestonClaudius Mahr - College Station Medical CenterJu H. Kim - Houston MethodistArvind Bhimaraj - Houston MethodistPaavni Sangal - Tufts Medical CenterQiuyue Kong - Tufts Medical CenterKarol D. Walec - Tufts Medical CenterPeter Zazzali - Tufts Medical CenterJustin Fried - Columbia University Irving Medical CenterDaniel Burkhoff - Cardiovascular Research FoundationNavin K. Kapur - Tufts Medical Center
- Publication Details
- Journal of the American College of Cardiology, v 84(11), pp 978-990
- Publisher
- Elsevier
- Number of pages
- 13
- Grant note
- CSI Abiomed Boston Scientific Inc; Boston Scientific Abbott Laboratories LivaNova Inc Abiomed Inc. Boston Scien-tific; Boston Scientific Abbott; Abbott Laboratories Zoll Abiomed Inc
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiology
- Web of Science ID
- WOS:001313529900001
- Scopus ID
- 2-s2.0-85204423575
- Other Identifier
- 991021932197604721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems