Title

TCT-812 Modified SCAI Classification for Cardiogenic Shock Is Associated With Increasing In-Hospital Mortality: A Report From the Cardiogenic Shock Working Group Registry

Document Type

Abstract

Publication Date

9-24-2019

Publication Title

Journal of the American College of Cardiology

Keywords

cards

Abstract

Background

Cardiogenic shock (CS) mortality remains prohibitively high. A major limitation has been the lack of registry data available for analysis. The National Cardiogenic Shock Working Group Registry (NCSWGR) is a multicenter retrospective database of patients with CS. We now provide an interim update on the registry and tested whether a modified version of the recent SCAI shock classification (Figure) is associated with in-hospital mortality.

Methods

We performed an analysis of the NCSWGR from 2017 to 2019. SCAI shock classifications were used. Class C and D shock patients were subdivided into 2 groups. Class C1 did not require any pressors or device therapy. Class C2 required 1 device or drug intervention. Class D1 required >1 drug but no device therapy. Class D2 required >1 drug and device therapy or multiple devices.

Results

The NCSWGR contains data from 1,565 patients with CS obtained from 8 medical centers across the United States. CS was managed without device therapy (14%), intra-aortic balloon pump (IABP) alone (27%), Impella alone or in combination with IABP (21%), venoarterial extracorporeal membrane oxygenation (ECMO) alone or in combination with either IABP or Impella (16%), or other combination of drug or device therapy (22%). SCAI class distribution was 4% class A or B, 7% class C1, 24% class C2, 4% class D1, and 61% class D2. Patients in class E were excluded. In-hospital mortality increased according to SCAI class (Figure).

Conclusion

We report data from the largest retrospective multicenter registry of CS inclusive of hemodynamic variables. Our findings suggest that a modified version of the SCAI shock classifications may correlate with in-hospital mortality.

Clinical Institute

Cardiovascular (Heart)

Department

Cardiology

Department

Center for Cardiovascular Analytics, Research + Data Science (CARDS)

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