🫀 Cardiogenic Shock Mortality Risk (CardShock)
The CardShock score uses seven admission variables to predict in-hospital mortality in cardiogenic shock.
Clinical takeaway
CardShock complements SCAI staging and the IABP-SHOCK II score, adding a quantitative early-mortality estimate (original synthesis · not guideline verbatim).
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When to use
Use early in cardiogenic shock to stratify mortality risk and inform escalation and transfer decisions.
How it works
Points (0–9) from age > 75, confusion, prior MI/CABG, ACS etiology, LVEF < 40%, lactate, and eGFR; low 0–3 (≈9%), intermediate 4–5 (≈36%), high 6–9 (≈77%) in-hospital mortality.
Key points
- CardShock complements SCAI staging and the IABP-SHOCK II score, adding a quantitative early-mortality estimate (original synthesis · not guideline verbatim).
- High scores justify early shock-team involvement and consideration of mechanical circulatory support.
- Lactate and eGFR carry up to 2 points each, reflecting the weight of perfusion and renal function.
References
- Harjola VP, et al. CardShock study. Eur J Heart Fail 2015.
- Pöss J, et al. Risk stratification in cardiogenic shock. JACC 2017.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age > 75 yr | No |
|---|---|
| Confusion at admission | No |
| Prior MI or CABG | No |
| ACS etiology | No |
| Left ventricular ejection fraction < 40% | No |
| Blood lactate | < 2 mmol/L (0) |
| eGFR | > 60 (0) |
→CardShock0 pts
- Class：0 pts (0–9) → Low risk (in-hospital mortality ≈9%)
- Management direction：Low risk: standard cardiogenic-shock management, monitor for change and reassess promptly
- Note：7 variables integrate age, mental status, cardiac history/etiology, LV function, perfusion (lactate), and renal function (eGFR). AUC ≈ 0.85 (development) / 0.71 (validation). Complementary to SCAI staging and the IABP-SHOCK II score
| Age > 75 yr | Yes (1) |
|---|---|
| Confusion at admission | Yes (1) |
| Prior MI or CABG | Yes (1) |
| ACS etiology | Yes (1) |
| Left ventricular ejection fraction < 40% | Yes (1) |
| Blood lactate | > 4 mmol/L (2) |
| eGFR | < 30 (2) |
→CardShock9 pts
- Class：9 pts (0–9) → High risk (in-hospital mortality ≈77%)
- Management direction：High risk: early multidisciplinary shock team, assess mechanical circulatory support, transfer to an experienced center; intensify monitoring and organ support
- Note：7 variables integrate age, mental status, cardiac history/etiology, LV function, perfusion (lactate), and renal function (eGFR). AUC ≈ 0.85 (development) / 0.71 (validation). Complementary to SCAI staging and the IABP-SHOCK II score
Frequently asked questions
- What is Cardiogenic Shock Mortality Risk (CardShock)?
- The CardShock score uses seven admission variables to predict in-hospital mortality in cardiogenic shock.
- How is Cardiogenic Shock Mortality Risk (CardShock) calculated? What is the core formula?
- Points (0–9) from age > 75, confusion, prior MI/CABG, ACS etiology, LVEF < 40%, lactate, and eGFR; low 0–3 (≈9%), intermediate 4–5 (≈36%), high 6–9 (≈77%) in-hospital mortality.
- When is Cardiogenic Shock Mortality Risk (CardShock) used?
- Use early in cardiogenic shock to stratify mortality risk and inform escalation and transfer decisions.
- What are the key clinical points for Cardiogenic Shock Mortality Risk (CardShock)?
- CardShock complements SCAI staging and the IABP-SHOCK II score, adding a quantitative early-mortality estimate (original synthesis · not guideline verbatim). High scores justify early shock-team involvement and consideration of mechanical circulatory support. Lactate and eGFR carry up to 2 points each, reflecting the weight of perfusion and renal function.
- What are the limits and cautions when using Cardiogenic Shock Mortality Risk (CardShock)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Cardiogenic Shock Mortality Risk (CardShock) calculated in practice? Can you show a worked example?
- Inputs: Age > 75 yr No, Confusion at admission No, Prior MI or CABG No, ACS etiology No, Left ventricular ejection fraction < 40% No, Blood lactate < 2 mmol/L (0), eGFR > 60 (0) → Result: CardShock 0 pts（Class: 0 pts (0–9) → Low risk (in-hospital mortality ≈9%), Management direction: Low risk: standard cardiogenic-shock management, monitor for change and reassess promptly, Note: 7 variables integrate age, mental status, cardiac history/etiology, LV function, perfusion (lactate), and renal function (eGFR). AUC ≈ 0.85 (development) / 0.71 (validation). Complementary to SCAI staging and the IABP-SHOCK II score） Inputs: Age > 75 yr Yes (1), Confusion at admission Yes (1), Prior MI or CABG Yes (1), ACS etiology Yes (1), Left ventricular ejection fraction < 40% Yes (1), Blood lactate > 4 mmol/L (2), eGFR < 30 (2) → Result: CardShock 9 pts（Class: 9 pts (0–9) → High risk (in-hospital mortality ≈77%), Management direction: High risk: early multidisciplinary shock team, assess mechanical circulatory support, transfer to an experienced center; intensify monitoring and organ support, Note: 7 variables integrate age, mental status, cardiac history/etiology, LV function, perfusion (lactate), and renal function (eGFR). AUC ≈ 0.85 (development) / 0.71 (validation). Complementary to SCAI staging and the IABP-SHOCK II score）