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SCAI SHOCK Stages Classification Expert Consensus Update: A Review and Incorporation of Validation Studies

Consensus Statement

Endorsed by the American College of Cardiology (ACC), American College of Emergency Physicians (ACEP), American Heart Association (AHA), European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC), Society of Critical Care Medicine (SCCM), International Society for Heart and Lung Transplantation (ISHLT) and the Society of Thoracic Surgeons (STS) in December 2021.

The statement clarifies the role of the SCAI SHOCK classification within a comprehensive 3-axis model incorporating other predictors of mortality, such as etiology, phenotype, and non-modifiable risk factors such as age and frailty. The updated classification provides more granularity to the cardiac arrest modifier and the constituent domains of the classification, including physical examination, biochemical, and hemodynamic criteria. 

“The new updated definition is easier to use, with tables that have eliminated relatively unnecessary variables and highlighted the more commonly present ones in each shock stage, a more useful cardiac arrest modifier, and a 3-axis model that places the shock stages in context of other variables that need to be considered for the patient in front of you.” - Srihari S. Naidu, MD, FSCAI, Chair of the writing group

SHOCK Pyramid Recreated web test 1.png

All authors: Srihari S. Naidu, MD, FSCAI; David A. Baran, MD, FSCAI; Jacob C. Jentzer, MD; Steven M. Hollenberg, MD; Sean van Diepen, MD, MSc; Mir B. Basir, DO, FSCAI; Cindy L. Grines, MD, MSCAI; Deborah B. Diercks, MD, MSc, FACEP; Shelley Hall, MD; Navin K. Kapur, MD, FSCAI; William Kent, MD, MSc; Sunil V. Rao, MD, FSCAI; Marc D. Samsky, MD; Holger Thiele, MD, FESC; Alexander G. Truesdell, MD, FSCAI; Timothy D. Henry, MD, MSCAI.

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