Comparison of risk prediction models in infarct-related cardiogenic shock
| Autor: | Holger Thiele, Keith G. Oldroyd, S Windecker, Uwe Zeymer, S De Waha-Thiele, David A. Baran, Gilles Montalescot, G Fuernau, Steffen Desch, Janine Poess, Hans-Josef Feistritzer, Maria Gimenez Rubini, Anne Freund, Steffen Schneider, Roza Meyer-Saraei |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Web of Science |
| ISSN: | 1522-9645 0195-668X |
| DOI: | 10.1093/eurheartj/ehab724.1531 |
| Popis: | Background Several prediction models have been developed to allow accurate risk assessment and provide better treatment guidance in patients with infarct-related cardiogenic shock (CS). However, comparative data between these models are still scarce. Objectives To externally validate different risk prediction models in infarct-related CS and compare their predictive value in the early clinical course. Methods The Simplified Acute Physiology Score (SAPS)-II Score, the CardShock score, the IABP-SHOCK II score and the Society for Cardiovascular Angiography and Intervention (SCAI) classification were each externally validated in a total of 1055 patients with infarct-related CS enrolled into the randomized CULPRIT-SHOCK trial or the corresponding registry. Discriminative power was assessed by comparing area under the curves (AUC) in case of continuous scores. Results In direct comparison of the continuous scores in a total of 161 patients, the IABP-SHOCK II score revealed best discrimination (AUC=0.74), followed by the CardShock score (AUC=0.69) and the SAPS-II score, giving only moderate discrimination (AUC=0.63). All of the three scores revealed acceptable calibration by Hosmer-Lemeshow test. The SCAI classification as a categorical predictive model displayed good prognostic assessment for the highest risk group (stage E), but showed poor discrimination between stages C and D with respect to short-term-mortality. Conclusion Based on the present findings, the IABP-SHOCK II score appears to be the most suitable of the examined models for immediate risk prediction in infarct-related CS. Prospective evaluation of the models, further modification or even development of new scores might be necessary to reach higher levels of discrimination. Funding Acknowledgement Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Union, German Centre for Cardiovascular Research Survival probabilities continuous scoresSurvival probabilities SCAI |
| Databáze: | OpenAIRE |
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