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Alberto Forteza GilAutor o CoautorSegovia-Cubero JAutor o Coautor

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Utilidad de las escalas de gravedad en la predicción de mortalidad intrahospitalaria en el shock cardiogénico. Propuesta de un nuevo modelo pronóstico

Publicado en:Revista Espanola de Anestesiologia y Reanimacion. 69 (2): 79-87 - 2022-01-01 69(2), DOI: 10.1016/j.redare.2021.03.010

Autores: Álvarez Avelló, José Manuel; Hernández Pérez, Francisco José; Herrero Cano, Ángela; López Ibor, Jorge V; Aymerich, M; Iranzo Valero, Reyes; Vidal Fernández, Mercedes; Gómez Bueno, Manuel F; Gómez Paratcha, Beatriz; García Suárez, Jessica; Martín de Diego, CE; Forteza Gil, Alberto; González Román, Ana Isabel; Segovia Cubero, Javier

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Resumen

Cardiogenic shock (CS) is a condition comprising multiple etiologies, which associates high mortality rates. Some scoring systems have been shown to be good predictors of hospital mortality in patients admitted to Critical Care Units (CCU). The main objective of this study is to analyze their usefulness and validity in a cohort of CS patients.Observational unicentric study of a cohort of CS patients. SOFA, SAPS II and APACHE II scores were calculated in the first 24 h of CCU admission.130 patients with CS were included. SOFA, SAPS II and APACHE II scores revealed good discrimination for hospital mortality: (AUC) ROC values (AUC: 0.711, 0.752 and 0.742 respectively; P = .6). Calibration, estimated by the Hosmer-Lemeshow test, was adequate in all cases. Acute coronary syndrome, lactate serum values, SAPS II score and vasoactive inotropic score (VIS) were found to be independent predictors for mortality, upon ICU admission. With these variables, a specific prognostic indicator was developed (SAPS-2-LIVE), which improved predictive capability for mortality in our series (AUC) ROC, 0.825 (95% CI 0.752-0.89).In this contemporary CS cohort, the aforementioned scores have been shown to have good predictive ability for hospital mortality. These findings could contribute to a more accurate risk stratification in CS.Copyright © 2021 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

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