{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T21:35:34Z","timestamp":1794000934424,"version":"4.8.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,12,5]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">One\u2010time assessment of the Society for Cardiovascular Angiography and Interventions (SCAI) shock classification robustly predicts mortality in the cardiac intensive care unit (CICU). We sought to determine whether serial SCAI shock classification could improve risk stratification.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Unique admissions to a single academic level 1 CICU from 2015 to 2018 were included in this retrospective cohort study. Electronic health record data were used to assign the SCAI shock stage during 4\u2010hour blocks of the first 24\u2009hours of CICU admission. Shock was defined as hypoperfusion (SCAI shock stage C, D, or E). In\u2010hospital death was evaluated using logistic regression. Among 2918 unique CICU patients, 1537 (52.7%) met criteria for shock during \u22651 block, and 266 (9.1%) died in the hospital. The SCAI shock stage on admission was: A, 37.6%; B, 31.5%; C, 25.9%; D, 1.8%; and E, 3.3%. Patients who met SCAI criteria for shock on admission (first 4\u2009hours) and those with worsening SCAI shock stage after admission were at higher risk for in\u2010hospital death. Each higher admission (adjusted odds ratio, 1.36 [95% CI, 1.18\u20131.56]; area under the receiver operating characteristic curve, 0.70), maximum (adjusted odds ratio, 1.59 [95% CI, 1.37\u20131.85]; area under the receiver operating characteristic curve, 0.73) and mean (adjusted odds ratio, 2.42 [95% CI, 1.99\u20132.95]; area under the receiver operating characteristic curve, 0.78) SCAI shock stage was incrementally associated with a higher in\u2010hospital mortality rate. Discrimination was highest for the mean SCAI shock stage (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). Each additional 4\u2010hour block meeting SCAI criteria for shock predicted a higher mortality rate (adjusted odds ratio, 1.15 [95% CI, 1.07\u20131.24]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Dynamic assessment of shock using serial SCAI shock classification assignment can improve mortality risk stratification in CICU patients by quantifying the magnitude and duration of shock.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.032748","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T13:18:35Z","timestamp":1699276715000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Serial Assessment of Shock Severity in Cardiac Intensive Care Unit Patients"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6366-2859","authenticated-orcid":false,"given":"Jacob C.","family":"Jentzer","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6688-828X","authenticated-orcid":false,"given":"Sean","family":"Van Diepen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine and Division of Cardiology, Department of Medicine University of Alberta Hospital Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2761-5895","authenticated-orcid":false,"given":"Parag C.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Florida Jacksonville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1123-0533","authenticated-orcid":false,"given":"Timothy D.","family":"Henry","sequence":"additional","affiliation":[{"name":"The Carl and Edyth Lindner Center for Research and Education at The Christ Hospital and The Christ Hospital Heart and Vascular Institute Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-5382","authenticated-orcid":false,"given":"David A.","family":"Morrow","sequence":"additional","affiliation":[{"name":"TIMI Study Group, Cardiovascular Division Brigham and Women\u2019s Hospital and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7754-9953","authenticated-orcid":false,"given":"David A.","family":"Baran","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Cleveland Clinic Florida Weston FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2184-3683","authenticated-orcid":false,"given":"Kianoush B.","family":"Kashani","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Division of Nephrology and Hypertension, Department of Medicine Mayo Clinic Rochester Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.05.012"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005618"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.2467"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.10.054"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28329"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.01.018"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2022.100120"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2022.12.007"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.07.077"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjacc\/zuac119"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.120.007099"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28707"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004948"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29319"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29139"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.30484"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.04.049"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2023.08.007"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001390"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000002123"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000001767"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008169"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2018.12.012"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.02.018"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.14.1754"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2020.07.031"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29692"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.123.032748","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:25:30Z","timestamp":1715603130000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.123.032748"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,5]]},"references-count":27,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2023,12,5]]}},"alternative-id":["10.1161\/JAHA.123.032748"],"URL":"https:\/\/doi.org\/10.1161\/jaha.123.032748","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,5]]},"assertion":[{"value":"2023-10-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e032748"}}