PMID- 31610748
OWN - NLM
STAT- MEDLINE
DCOM- 20210729
LR  - 20220418
IS  - 1525-1489 (Electronic)
IS  - 0885-0666 (Linking)
VI  - 35
IP  - 12
DP  - 2020 Dec
TI  - Comparative Prognostic Accuracy of Risk Prediction Models for Cardiogenic Shock.
PG  - 1513-1519
LID - 10.1177/0885066619878125 [doi]
AB  - OBJECTIVES: Despite advances in medical therapy, reperfusion, and mechanical 
      support, cardiogenic shock remains associated with excess morbidity and 
      mortality. Accurate risk stratification may improve patient management. We 
      compared the accuracy of established risk scores for cardiogenic shock. METHODS: 
      Patients admitted to tertiary care center cardiac care units in the province of 
      Alberta in 2015 were assessed for cardiogenic shock. The Acute Physiology and 
      Chronic Health Evaluation-II (APACHE-II), CardShock, intra-aortic balloon pump 
      (IABP) Shock II, and sepsis-related organ failure assessment (SOFA) risk scores 
      were compared. Receiver operating characteristic curves were used to assess 
      discrimination of in-hospital mortality and compared using DeLong's method. 
      Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test. RESULTS: 
      The study included 3021 patients, among whom 510 (16.9%) had cardiogenic shock. 
      Patients with cardiogenic shock had longer median hospital stays (median 11.0 vs 
      4.1 days, P < .001) and were more likely to die (29.0% vs 2.5%, P < .001). All 
      risk scores were adequately calibrated for predicting hospital morality except 
      for the APACHE-II score (Hosmer-Lemeshow P < .001). Discrimination of in-hospital 
      mortality with the APACHE-II (area under the curve [AUC]: 0.72, 95% confidence 
      interval [CI]: 0.66-0.76) and IABP-Shock II (AUC: 0.73, 95% CI: 0.68-0.77) scores 
      were similar, while the CardShock (AUC: 0.76, 95% CI: 0.72-0.81) and SOFA (AUC: 
      0.76, 95%CI: 0.72-0.81) scores had better discrimination for predicting 
      in-hospital mortality. CONCLUSIONS: In a real-world population of patients with 
      cardiogenic shock, existing risk scores had modest prognostic accuracy, with no 
      clear superior score. Further investigation is required to improve the 
      discriminative abilities of existing models or establish novel methods.
FAU - Miller, Robert J H
AU  - Miller RJH
AUID- ORCID: 0000-0003-4676-2433
AD  - Department of Cardiac Sciences, 157745Libin Cardiovascular Institute of Alberta, 
      Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - Southern, Danielle
AU  - Southern D
AD  - Department of Community Health Sciences, O'Brien Institute for Public Health, 
      Cumming School of Medicine, 2129University of Calgary, Calgary, Alberta, Canada.
FAU - Wilton, Stephen B
AU  - Wilton SB
AD  - Department of Cardiac Sciences, 157745Libin Cardiovascular Institute of Alberta, 
      Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
AD  - Department of Community Health Sciences, O'Brien Institute for Public Health, 
      Cumming School of Medicine, 2129University of Calgary, Calgary, Alberta, Canada.
FAU - James, Matthew T
AU  - James MT
AD  - Department of Community Health Sciences, O'Brien Institute for Public Health, 
      Cumming School of Medicine, 2129University of Calgary, Calgary, Alberta, Canada.
AD  - Department of Medicine, 157745Libin Cardiovascular Institute of Alberta, Cumming 
      School of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - Har, Bryan
AU  - Har B
AD  - Department of Cardiac Sciences, 157745Libin Cardiovascular Institute of Alberta, 
      Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - Schnell, Greg
AU  - Schnell G
AD  - Department of Cardiac Sciences, 157745Libin Cardiovascular Institute of Alberta, 
      Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - van Diepen, Sean
AU  - van Diepen S
AD  - Division of Cardiology, Department of Critical Care, Faculty of Medicine, 
      3158University of Alberta, Edmonton, Alberta, Canada.
FAU - Grant, Andrew D M
AU  - Grant ADM
AD  - Department of Cardiac Sciences, 157745Libin Cardiovascular Institute of Alberta, 
      Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
LA  - eng
PT  - Journal Article
DEP - 20191014
PL  - United States
TA  - J Intensive Care Med
JT  - Journal of intensive care medicine
JID - 8610344
SB  - IM
MH  - APACHE
MH  - Alberta
MH  - Humans
MH  - Intensive Care Units
MH  - *Organ Dysfunction Scores
MH  - Prognosis
MH  - ROC Curve
MH  - Retrospective Studies
MH  - *Shock, Cardiogenic
OTO - NOTNLM
OT  - acute coronary syndrome
OT  - cardiogenic shock
OT  - risk prediction
OT  - shock
EDAT- 2019/10/16 06:00
MHDA- 2021/07/30 06:00
CRDT- 2019/10/16 06:00
PHST- 2019/10/16 06:00 [pubmed]
PHST- 2021/07/30 06:00 [medline]
PHST- 2019/10/16 06:00 [entrez]
AID - 10.1177/0885066619878125 [doi]
PST - ppublish
SO  - J Intensive Care Med. 2020 Dec;35(12):1513-1519. doi: 10.1177/0885066619878125. 
      Epub 2019 Oct 14.