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@article{1307916,
author = {Harjola, VeliandPeka and Lassus, Johan and Sionis, Alessandro and Kober, Lars and Tarvasmaki, Tuukka and Špinar, Jindřich and Parissis, John and Banaszewski, Marek and SilvaandCardoso, Jose and Carubelli, Valentina and Di Somma, Salvatore and Tolppanen, Heli and Zeymer, Uwe and Thiele, Holger and Nieminen, Markku S. and Mebazaa, Alexandre},
article_location = {Great Britain},
article_number = {5},
doi = {http://dx.doi.org/10.1002/ejhf.260},
keywords = {Cardiogenic shock; Prognosis; Risk score; Acute myocardial infarction; Acute coronary syndromes; Management},
language = {eng},
issn = {1388-9842},
journal = {European Journal of heart Failure},
title = {Clinical picture and risk prediction of short-term mortality in cardiogenic shock},
volume = {17},
year = {2015}
}
TY - JOUR
ID - 1307916
AU - Harjola, Veli-Peka - Lassus, Johan - Sionis, Alessandro - Kober, Lars - Tarvasmaki, Tuukka - Špinar, Jindřich - Parissis, John - Banaszewski, Marek - Silva-Cardoso, Jose - Carubelli, Valentina - Di Somma, Salvatore - Tolppanen, Heli - Zeymer, Uwe - Thiele, Holger - Nieminen, Markku S. - Mebazaa, Alexandre
PY - 2015
TI - Clinical picture and risk prediction of short-term mortality in cardiogenic shock
JF - European Journal of heart Failure
VL - 17
IS - 5
SP - 501-509
EP - 501-509
PB - Elsevier Science
SN - 13889842
KW - Cardiogenic shock
KW - Prognosis
KW - Risk score
KW - Acute myocardial infarction
KW - Acute coronary syndromes
KW - Management
N2 - AimsThe aim of this study was to investigate the clinical picture and outcome of cardiogenic shock and to develop a risk prediction score for short-term mortality. Methods and resultsThe CardShock study was a multicentre, prospective, observational study conducted between 2010 and 2012. Patients with either acute coronary syndrome (ACS) or non-ACS aetiologies were enrolled within 6h from detection of cardiogenic shock defined as severe hypotension with clinical signs of hypoperfusion and/or serum lactate >2mmol/L despite fluid resuscitation (n = 219, mean age 67, 74% men). Data on clinical presentation, management, and biochemical variables were compared between different aetiologies of shock. Systolic blood pressure was on average 78 mmHg (standard deviation 14 mmHg) and mean arterial pressure 57 (11) mmHg. The most common cause (81%) was ACS (68% ST-elevation myocardial infarction and 8% mechanical complications); 94% underwent coronary angiography, of which 89% PCI. Main non-ACS aetiologies were severe chronic heart failure and valvular causes. In-hospital mortality was 37% (n = 80). ACS aetiology, age, previous myocardial infarction, prior coronary artery bypass, confusion, low LVEF, and blood lactate levels were independently associated with increased mortality. The CardShock risk Score including these variables and estimated glomerular filtration rate predicted in-hospital mortality well (area under the curve 0.85). ConclusionAlthough most commonly due to ACS, other causes account for one-fifth of cases with shock. ACS is independently associated with in-hospital mortality. The CardShock risk Score, consisting of seven common variables, easily stratifies risk of short-term mortality. It might facilitate early decision-making in intensive care or guide patient selection in clinical trials.
ER -
HARJOLA, Veli-Peka, Johan LASSUS, Alessandro SIONIS, Lars KOBER, Tuukka TARVASMAKI, Jindřich ŠPINAR, John PARISSIS, Marek BANASZEWSKI, Jose SILVA-CARDOSO, Valentina CARUBELLI, Salvatore DI SOMMA, Heli TOLPPANEN, Uwe ZEYMER, Holger THIELE, Markku S. NIEMINEN and Alexandre MEBAZAA. Clinical picture and risk prediction of short-term mortality in cardiogenic shock. \textit{European Journal of heart Failure}. Great Britain: Elsevier Science, 2015, vol.~17, No~5, p.~501-509. ISSN~1388-9842. Available from: https://dx.doi.org/10.1002/ejhf.260.
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