🫀 Cardiogenic Shock Staging (SCAI SHOCK)
SCAI SHOCK staging classifies cardiogenic shock into five graded stages (A–E) tied to rising in-hospital mortality.
Clinical takeaway
Staging integrates physical signs, lactate, and hemodynamics — initial staging need not wait for invasive monitoring (original synthesis · not guideline verbatim).
Loading calculator…
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
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.
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.
| Stage (choose the best fit) | A At risk: ACS or decompensated heart failure, no shock, normal perfusion and blood pressure |
|---|---|
| Cardiac arrest (CPR/defibrillation with coma) | No |
→SCAI stageStage A
- Stage：Stage A (in-hospital mortality ≈3%, Jentzer Mayo CICU cohort)
- Management direction：Monitor, treat the underlying disease (ACS reperfusion / heart-failure optimization), watch closely for progression
- Dynamic nature：Cardiogenic shock is a dynamic process: most patients change stage within 24 h — serial reassessment is required to guide escalation/de-escalation of support
| Stage (choose the best fit) | E Extremis: circulatory collapse/refractory shock (SBP < 80 or MAP < 50 on multiple agents), often with cardiac arrest |
|---|---|
| Cardiac arrest (CPR/defibrillation with coma) | Yes (add (A) modifier) |
→SCAI stageStage E(A)
- Stage：Stage E(A) (in-hospital mortality ≈67%, Jentzer Mayo CICU cohort)
- Management direction：Maximize resuscitation/MCS, ECPR if needed; multidisciplinary assessment of prognosis and goals of care
- Dynamic nature：Cardiogenic shock is a dynamic process: most patients change stage within 24 h — serial reassessment is required to guide escalation/de-escalation of support
Frequently asked questions
- What is Cardiogenic Shock Staging (SCAI SHOCK)?
- SCAI SHOCK staging classifies cardiogenic shock into five graded stages (A–E) tied to rising in-hospital mortality.
- How is Cardiogenic Shock Staging (SCAI SHOCK) calculated? What is the core formula?
- 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.
- When is Cardiogenic Shock Staging (SCAI SHOCK) used?
- Use to stage cardiogenic shock at the bedside and guide escalation-of-support and shock-team activation decisions.
- What are the key clinical points for Cardiogenic Shock Staging (SCAI SHOCK)?
- 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.
- What are the limits and cautions when using Cardiogenic Shock Staging (SCAI SHOCK)?
- 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 Staging (SCAI SHOCK) calculated in practice? Can you show a worked example?
- Inputs: Stage (choose the best fit) A At risk: ACS or decompensated heart failure, no shock, normal perfusion and blood pressure, Cardiac arrest (CPR/defibrillation with coma) No → Result: SCAI stage Stage A（Stage: Stage A (in-hospital mortality ≈3%, Jentzer Mayo CICU cohort), Management direction: Monitor, treat the underlying disease (ACS reperfusion / heart-failure optimization), watch closely for progression, Dynamic nature: Cardiogenic shock is a dynamic process: most patients change stage within 24 h — serial reassessment is required to guide escalation/de-escalation of support） Inputs: Stage (choose the best fit) E Extremis: circulatory collapse/refractory shock (SBP < 80 or MAP < 50 on multiple agents), often with cardiac arrest, Cardiac arrest (CPR/defibrillation with coma) Yes (add (A) modifier) → Result: SCAI stage Stage E(A)（Stage: Stage E(A) (in-hospital mortality ≈67%, Jentzer Mayo CICU cohort), Management direction: Maximize resuscitation/MCS, ECPR if needed; multidisciplinary assessment of prognosis and goals of care, Dynamic nature: Cardiogenic shock is a dynamic process: most patients change stage within 24 h — serial reassessment is required to guide escalation/de-escalation of support）