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Original Article
- Cardiology
- Prognostic validation and risk stratification of the Society for Cardiovascular Angiography and Interventions cardiogenic shock classification in a large, real-world intensive care unit cohort in South Korea
- Haechan Cho, Jeehoon Kang, Minju Han, Huijin Lee, Hyun-Jai Cho
- Acute Crit Care. 2026;41(1):117-125. Published online February 27, 2026
- DOI: https://doi.org/10.4266/acc.004500
- 1,278 View
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Abstract
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Supplementary Material - Background
Cardiogenic shock (CS) imparts a high mortality rate, yet a standardized classification of its severity remains lacking. The Society for Cardiovascular Angiography and Interventions (SCAI) proposed a five-stage classification scheme to improve risk stratification, but its prognostic value in real-world intensive care unit (ICU) populations is still insufficiently validated. Methods: We retrospectively analyzed 3,074 adults admitted to the medical and cardiovascular ICUs under the Division of Cardiology at a tertiary academic medical center between 2010 and 2019. SCAI shock stages (A–E) were assigned at admission using data on hemodynamic instability, hypoperfusion, clinical deterioration, and refractory shock. The primary outcome was ICU mortality. Results: ICU mortality rates across stages A–E were 0.5%, 4.3%, 5.2%, 18.8%, and 53.2% (P<0.001). Compared to stage A, higher stages were independently associated with mortality (adjusted odds ratio, 3.93–31.58). The discriminatory ability of the SCAI CS classification was moderate (area under the receiver operating characteristic curve [AUROC], 0.787) but improved markedly with the addition of Acute Physiology and Chronic Health Evaluation II scores (AUROC, 0.929). Conclusions: The SCAI CS classification offers clear, incremental risk stratification of ICU mortality. When combined with global severity scores, it provides superior prognostic accuracy, supporting its routine use in the management and study of CS.
Letter to the Editor
- Rapid response system
- Current status of the rapid response system and early warning score: a survey-based analysis
- Sang-Hyeon Park, Jeehoon Kang, Tae Jung Kim, Hong Yeul Lee, Hyun-Jai Cho, Sang-Min Lee
- Acute Crit Care. 2022;37(4):687-689. Published online November 21, 2022
- DOI: https://doi.org/10.4266/acc.2022.01144
- 4,729 View
- 134 Download
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