Consistency and Risk Stratification Performance of 4 Society for Cardiovascular Angiography and Interventions SHOCK...

Area of Science:

• Cardiology
• Clinical Research

Background:

• Cardiogenic shock (CS) presents a critical challenge with high mortality rates, necessitating precise diagnostic tools.
• The Society for Cardiovascular Angiography and Interventions (SCAI) SHOCK Stage Classification is a key instrument for CS assessment and outcome prediction.

Purpose of the Study:

• To evaluate the impact of varying parameter definitions on SCAI SHOCK stage adjudication.
• To assess how definition variations influence CS assessment and patient stratification.

Main Methods:

• Retrospective analysis of 1281 patients diagnosed with CS between January 2018 and June 2022.
• Assignment of SCAI SHOCK stages based on four distinct published classification frameworks.
• Assessment of stage distribution, outcomes, classification concordance, and predictive performance.

Main Results:

• A high concordance (98.2%) was observed across the four SCAI SHOCK classification frameworks.
• Moderate to strong overall classification agreement (Kendall's W=0.70) was found, despite variations in stage assignment and mortality rates.
• No significant differences in the predictive performance for in-hospital mortality were detected among the frameworks.

Conclusions:

• The study confirms moderate to strong concordance and comparable prognostic performance of different SCAI SHOCK Stage Classification frameworks.
• All frameworks successfully stratified patients based on clinical severity, underscoring their utility in CS evaluation.
• Standardization of the SCAI SHOCK Stage Classification system is recommended for consistent retrospective study assignments.