ArticleJACC. Asia2025
Using a Cardiogenic Shock Classification System for Predicting Postcardiotomy Shock Mortality.
Article in JACC. Asia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- The Role of SCAI Classification in Postcardiotomy Cardiogenic Shock Risk Stratification.JACC. Asia · 2025Article
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12 authors.
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Abstract
backgroundCardiogenic shock (CS) is a life-threatening hemodynamic state. Patients with differing shock severity show varying responsiveness to clinical interventions. CS also occurs in patients who have undergone cardiac surgery. A few evaluation systems have been developed for postcardiotomy patients. The Society for Cardiovascular Angiography and Intervention (SCAI) has developed a new classification scheme for CS.
objectivesThis study aimed to assess the parameters that define the stages of CS and the diagnostic utility of an SCAI-based CS classification system for patients undergoing cardiac surgery to inform the prediction of outcomes.
methodsThis single-center, retrospective, observational study included 8,335 consecutive adult patients undergoing cardiac surgery from January to December 2022. This cohort was divided into 5 groups based on lactate and types of intervention received, including vasopressors and mechanical circulatory support systems. The primary outcome was in-hospital mortality.
resultsCS occurred in 970 (11.1%) patients of this cohort. The frequencies of distribution of various postcardiotomy shock stages differed significantly: stage A = 4,747 (57.0%), stage B = 2,658 (31.9%), stage C = 779 (9.3%), stage D = 64 (0.8%), and stage E = 87 (1.0%) (P < 0.001) patients. In-hospital mortality was 1.1% (94 of 8,335). A progressive increase in the stage of the disease led to a clear stepwise increase in in-hospital mortality: Stage A = 0.4% (19 of 4747), Stage B = 0.8% (21 of 2658), Stage C = 2.8% (22 of 779), Stage D = 7.8% (5 of 64), and Stage E = 31.0% (27 of 87) (P < 0.001). The area under the receiver-operating curve of this classification for postcardiotomy CS was 0.781 (95% CI: 0.746-0.815).
conclusionsIn this single-center postcardiotomy population, CS occurred in 11.1% of patients. Postcardiotomy SCAI-derived criteria for CS severity suggested a good correlation with in-hospital mortality.
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