🫀 Cardiogenic Shock Staging (SCAI SHOCK)
SCAI SHOCK staging classifies cardiogenic shock into five graded stages (A–E) tied to rising in-hospital mortality.
Cardiogenic Shock Staging (SCAI SHOCK)
Stage (choose the best fit)
Cardiac arrest (CPR/defibrillation with coma)
When to use
Use to stage cardiogenic shock at the bedside and guide escalation-of-support and shock-team activation decisions.
How it works
A at-risk → B beginning/pre-shock → C classic (needs intervention) → D deteriorating → E extremis; in-hospital mortality rises ~3% → 7% → 12% → 40% → 67%; cardiac arrest adds an (A) modifier.
Key points
- Staging integrates physical signs, lactate, and hemodynamics — initial staging need not wait for invasive monitoring (original synthesis · not guideline verbatim).
- Shock is dynamic: most patients change stage within 24 h, so serial reassessment drives escalation or de-escalation.
- The (A) cardiac-arrest modifier flags a worse prognostic trajectory independent of the base stage.
References
- Baran DA, et al. SCAI SHOCK consensus. Catheter Cardiovasc Interv 2019.
- Naidu SS, et al. SCAI SHOCK 2022 update. JACC 2022.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.