| Autor: |
Arias FG; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Alonso-Fernandez-Gatta M; Department of Cardiology, Hospital Universitario de Salamanca-IBSAL, University of Salamanca., Dominguez MP; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Martínez JM; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Veloso PR; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Bermejo RMA; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Álvarez DI; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Merchán-Gómez S; Department of Cardiology, Hospital Universitario de Salamanca-IBSAL, University of Salamanca., Diego-Nieto A; Department of Cardiology, Hospital Universitario de Salamanca-IBSAL, University of Salamanca., Casas CAJ; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Álvarez BÁ; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Ferrero TG; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Antonio CC; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Muiños PJA; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV).; Department of Cardiology, Hospital Universitario de Salamanca-IBSAL, University of Salamanca., Acuña JMG; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV)., Sánchez PL; Department of Cardiology, Hospital Universitario de Salamanca-IBSAL, University of Salamanca., Juanatey JRG; Department of Department, Complejo Hospitalario Universitario de Santiago de Compostela.; Biomedical Research Networking Center on Cardiovascular Diseases (CIBERCV). |
| Abstrakt: |
Cardiogenic shock (CS) is a condition associated with high morbidity and mortality. Our study aimed to perform a risk score for in-hospital mortality that allows for stratifying the risk of death in patients with CS.This is a retrospective analysis, which included 135 patients from a Spanish university hospital between 2011 and 2020. The Santiago Shock Score (S3) was created using clinical, analytical, and echocardiographic variables obtained at the time of admission.The in-hospital mortality rate was 41.5%, and acute coronary syndrome (ACS) was the responsible cause of shock in 60.7% of patients. Mitral regurgitation grade III-IV, age, ACS etiology, NT-proBNP, blood hemoglobin, and lactate at admission were included in the score. The S3 had good accuracy for predicting in-hospital mortality area under the receiver operating characteristic curve (AUC) 0.85 (95% confidence interval (CI) 0.78-0.90), higher than the AUC of the CardShock score, which was 0.74 (95% CI 0.66-0.83). Predictive power in a cohort of 131 patients with profound CS was similar to that of CardShock with an AUC of 0.601 (95% CI 0.496-0.706) versus an AUC of 0.558 (95% CI 0.453-0.664). Three risk categories were created according to the S3: low (scores 0-6), intermediate (scores 7-10), and high (scores 11-16) risks, with an observed mortality of 12.9%, 49.1%, and 87.5% respectively (P < 0.001).The S3 score had excellent predictive power for in-hospital mortality in patients with nonprofound CS. It could aid the initial risk stratification of patients and thus, guide treatment and clinical decision making in patients with CS. |
