The Intra-Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock (IABP-SHOCK II) risk score

Cardiogenic shock complicating acute myocardial infarction: IABP-SHOCK II RISK SCORE. Risk assessment of 30-day mortality.

Age > 73 years
Yes
No

History of stroke:
Yes
No

Glucose > 10.6 mmol/l (191 mg/dl):
Yes
No

Creatinine > 132.6 mmol/l (1.5 mg/dl):
Yes
No

Arterial lactate > 5 mmol/l*:
Yes
No

TIMI flow grade < 3 after PCI:
Yes
No




Patient’s IABP-SHOCK II score Risk categories Points
0 0 0

Mortality from cardiogenic shock remains high and early recognition and risk stratification are mandatory for optimal patient allocation and to guide treatment strategy.

The Intra-Aortic Balloon Counterpulsation in Acute Myocardial Infarction Complicated by Cardiogenic Shock (IABP-SHOCK II) risk score has shown good results in predicting short-term mortality in cardiogenic shock.

The IABP-SHOCK II risk score is a simple tool that can be rapidly calculated in the catheterization laboratory setting and applied in clinical routine. It might therefore serve for identifying patients for future clinical trials and, more importantly, it might help stratify patients according to their risk for short-term mortality and thus facilitate clinical decision making. The scoring system attributed one or two points per variable.

SCORE
VariablePoints
Age > 73 years1
History of stroke2
Glucose > 10.6 mmol/l (191 mg/dl) 1
Creatinine > 132.6 mmol/l (1.5 mg/dl)1
Arterial lactate > 5 mmol/l2
TIMI flow grade < 3 after PCI2
Maximum9

Interpretation

RISK CATEGORIES
CategoryPoints
Low0-2
Intermediate3-4
High5-9

Cardiogenic Shock Complicating Acute Myocardial Infarction

The IABP-SHOCK II risk score can be easily calculated in daily clinical practice and strongly correlated with mortality in patients with infarct-related CS. It may help stratify patient risk for short-term mortality and might, thus, facilitate clinical decision making.

Source:
1. Pöss J, Köster J, Fuervan G, et al. J Am Coll Cardiol 2017; 69:1913–20
2. Douglas JS. Primary PCI: Outcomes and Quality Assessment. 2018 Jul 14. In: Watson TJ, Ong PJL, Tcheng JE, editors. Primary Angioplasty: A Practical Guide [Internet]. Singapore: Springer; 2018. Fig. 23.5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK543591/figure/ch23.Fig5/ doi: 10.1007/978-981-13-1114-7_23
3. Rivas-Lasarte M, Sans-Roselló J, Collado-Lledó E, et al. External validation and comparison of the CardShock and IABP-SHOCK II risk scores in real-world cardiogenic shock patients. European Heart Journal: Acute Cardiovascular Care. January 2020. doi:10.1177/2048872619895230 https://journals.sagepub.com/doi/abs/10.1177/2048872619895230?journalCode=acca

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