Updated SCAI SHOCK Stages Classification
The SCAI SHOCK classification is intended to provide clinicians and researchers with a unified and standardized vocabulary that will translate across all settings. Additionally, the system aims to facilitate recognition of risk for adverse outcomes, potential for benefit from various interventions and prognosis, with the goal of reducing mortality on an individual as well as a national scale.
The latest update includes a 3-axis model that places the shock stage in context with other predictors of mortality, such as etiology, phenotype, and non-modifiable risk factors such as age and frailty. It also provides a more useful cardiac arrest modifier and clarifies the constituent domains of the classification, including physical examination, biochemical, and hemodynamic criteria.
Bedside Checklist
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Quality Improvement Tool
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This educational tool provides users with organized high-yield information to assist them with the following:
- Identifying and staging patients with cardiogenic shock before clinical deterioration occurs.
- Optimizing interdisciplinary communication between providers taking care of shock patients.
Suitable for use as a point-of-care reference in high-acuity patient settings, such as the cardiac cath lab, intensive care unit, emergency department, or any rapid-response area, this tool is also appropriate for use at the patient's bedside to provide an efficient yet thorough approach to identifying patients with cardiogenic shock. Once shock is identified, the tool guides team members through additional information gathering and interdisciplinary communication requirements.
Validation Studies
- “Influence of intra-aortic balloon pump on mortality as a function of cardiogenic shock severity” (Jentzer, et al)
- “Clinical Outcomes Associated with Acute Mechanical Circulatory Support Utilization in Heart Failure Related Cardiogenic Shock” (Hernandez-Montfort, et al)
- “Incidence and outcomes of acute kidney injury stratified by cardiogenic shock severity” (Padkins, et al)
- “The Range of Cardiogenic Shock Survival by Clinical Stage: Data From the Critical Care Cardiology Trials Network Registry” (Lawler, et al)
- “Systemic Inflammatory Response Syndrome Is Associated With Increased Mortality Across the Spectrum of Shock Severity in Cardiac Intensive Care Patients” (Jentzer, et al)
- “Defining Shock and Preshock for Mortality Risk Stratification in Cardiac Intensive Care Unit Patients” (Jentzer, et al)
- “The Stages of CS: Clinical and Translational Update” (Baran, et al)
- “Complete Hemodynamic Profiling With Pulmonary Artery Catheters in Cardiogenic Shock Is Associated With Lower In-Hospital Mortality” (Kapur, et al)
- “Prospective validation of the SCAI shock classification: Single center analysis” (Baran, et al)
- “Invasive Hemodynamic Assessment and Classification of In-Hospital Mortality Risk Among Patients With Cardiogenic Shock” (Thayer, et al)
- “Understanding Cardiogenic Shock Severity and Mortality Risk Assessment” (Jentzer, et al)
- “SCAI shock classification in acute myocardial infarction: Insights from the National Cardiogenic Shock Initiative” (Hanson, et al)
- “Cardiogenic Shock Classification to Predict Mortality in the Cardiac Intensive Care Unit” (Jentzer, et al)
- “Admission SCAI shock stage stratifies post-discharge mortality risk in cardiac intensive care unit patients” (Jentzer, et al)
- “Application of the SCAI classification in a cohort of patients with cardiogenic shock” (Westermann, et al)
- “SCAI cardiogenic shock classification after out of hospital cardiac arrest and association with outcome?”
Online Learning
Complete these online educational activities to learn more about advances in cardiogenic shock treatment in the cath lab and access a wealth of trusted, quality online resources from past SCAI SHOCK meetings, including recorded presentations and downloadable PowerPoints in the SCAI conference library.