{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T02:17:46Z","timestamp":1772245066946,"version":"3.50.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is currently a lack of easy-to-use tools for assessing the severity of cardiogenic shock (CS) patients. This study aims to develop a nomogram for evaluating severity in CS patients regardless of the underlying cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>\n                      The MIMIC-IV database was used to identify 1,923 CS patients admitted to the ICU. A multivariate Cox model was developed in the training cohort (70%) based on LASSO regression results. Factors such as age, systolic blood pressure, arterial oxygen saturation, hemoglobin, serum creatinine, blood glucose, arterial pH, arterial lactate, and norepinephrine use were incorporated into the final model. This model was visualized as a Cardiogenic Shock Survival Nomogram (CSSN) to predict 30-day survival rates. The model's c-statistic was 0.75 (95% CI: 0.73\u20130.77) in the training cohort and 0.73 (95% CI: 0.70\u20130.77) in the validation cohort, demonstrating good predictive accuracy. The AUC of the CSSN for 30-day survival probabilities was 0.76 in the training cohort and 0.73 in the validation cohort. Calibration plots showed strong concordance between predicted and actual survival rates, and decision curve analysis (DCA) affirmed the model's clinical utility. The CSSN outperformed the Cardiogenic Shock Score (CSS) in various metrics, including c-statistic, time-dependent ROC, calibration plots, and DCA (c-statistic: 0.75 vs. 0.72; AUC: 0.76 vs. 0.73,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01 by Delong test). Subgroup analysis confirmed the model's robustness across both AMI-CS and non-AMI-CS subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CSSN was developed to predict 30-day survival rates in CS patients irrespective of the underlying cause, showing good performance and potential clinical utility in managing CS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2025.1538395","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T01:24:32Z","timestamp":1745889872000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a nomogram for predicting survival in patients with cardiogenic shock"],"prefix":"10.3389","volume":"12","author":[{"given":"Dingfeng","family":"Fang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huihe","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Geng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiahuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meilin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"482","DOI":"10.4244\/eij-d-23-00204","article-title":"Venoarterial extracorporeal membrane oxygenation or standard care in patients with cardiogenic shock complicating acute myocardial infarction: the multicentre, randomised euro shock trial","volume":"19","author":"Banning","year":"2023","journal-title":"EuroIntervention"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1056\/NEJMoa2307227","article-title":"Extracorporeal life support in infarct-related cardiogenic shock","volume":"389","author":"Thiele","year":"2023","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/mcc.0000000000000845","article-title":"Epidemiology and causes of cardiogenic shock","volume":"27","author":"Berg","year":"2021","journal-title":"Curr Opin Crit Care"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2535","DOI":"10.1093\/eurheartj\/ehs264","article-title":"Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the usik 1995, usic 2000, and fast-mi French nationwide registries","volume":"33","author":"Aissaoui","year":"2012","journal-title":"Eur Heart J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e007924","DOI":"10.1161\/circheartfailure.120.007924","article-title":"Clinical outcomes associated with acute mechanical circulatory support utilization in heart failure related cardiogenic shock","volume":"14","author":"Hernandez-Montfort","year":"2021","journal-title":"Circ Heart Fail"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1016\/j.jacc.2019.07.077","article-title":"Cardiogenic shock classification to predict mortality in the cardiac intensive care unit","volume":"74","author":"Jentzer","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.1016\/j.jacc.2017.02.027","article-title":"Risk stratification for patients in cardiogenic shock after acute myocardial infarction","volume":"69","author":"P\u00f6ss","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1002\/ejhf.260","article-title":"Clinical picture and risk prediction of short-term mortality in cardiogenic shock","volume":"17","author":"Harjola","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"B9","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1002\/ejhf.2449","article-title":"Early risk stratification in patients with cardiogenic shock irrespective of the underlying cause\u2014the cardiogenic shock score","volume":"24","author":"Beer","year":"2022","journal-title":"Eur J Heart Fail"},{"key":"B10","doi-asserted-by":"publisher","first-page":"105","DOI":"10.21147\/j.issn.1000-9604.2020.01.12","article-title":"A nomogram to preoperatively predict 1-year disease-specific survival in resected pancreatic cancer following neoadjuvant chemoradiation therapy","volume":"32","author":"Hwang","year":"2020","journal-title":"Chin J Cancer Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"E713","DOI":"10.1097\/brs.0000000000003404","article-title":"A nomogram and a risk classification system predicting the cancer-specific survival of patients with initially-diagnosed osseous spinal and pelvic tumors","volume":"45","author":"Zhou","year":"2020","journal-title":"Spine"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e005618","DOI":"10.1161\/circoutcomes.119.005618","article-title":"Epidemiology of shock in contemporary cardiac intensive care units","volume":"12","author":"Berg","year":"2019","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"B13","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1002\/ccd.28329","article-title":"Scai clinical expert consensus statement on the classification of cardiogenic shock: this document was endorsed by the American college of cardiology (acc), the American Heart Association (aha), the society of critical care medicine (sccm), and the society of thoracic surgeons (Sts) in April 2019","volume":"94","author":"Baran","year":"2019","journal-title":"Catheter Cardiovasc Interv"},{"key":"B14","doi-asserted-by":"publisher","first-page":"E215","DOI":"10.1161\/01.cir.101.23.e215","article-title":"Physiobank, physiotoolkit, and physionet: components of a new research resource for complex physiologic signals","volume":"101","author":"Goldberger","year":"2000","journal-title":"Circulation"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.13026\/6mm1-ek67","article-title":"MIMIC-IV (version 2.2)","author":"Johnson","year":"2023","journal-title":"PhysioNet"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41597-022-01899-x","article-title":"Mimic-Iv, a freely accessible electronic health record dataset","volume":"10","author":"Johnson","year":"2023","journal-title":"Sci Data"},{"key":"B17","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1161\/circulationaha.118.038201","article-title":"Intraaortic balloon pump in cardiogenic shock complicating acute myocardial infarction: long-term 6-year outcome of the randomized iabp-shock ii trial","volume":"139","author":"Thiele","year":"2019","journal-title":"Circulation"},{"key":"B18","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1186\/s12872-023-03465-8","article-title":"Effects of intra-aortic balloon pump on in-hospital outcomes and 1-year mortality in patients with acute myocardial infarction complicated by cardiogenic shock","volume":"23","author":"Fang","year":"2023","journal-title":"BMC Cardiovasc Disord"},{"key":"B19","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1161\/circulationaha.122.062949","article-title":"Extracorporeal membrane oxygenation in the therapy of cardiogenic shock: results of the ecmo-cs randomized clinical trial","volume":"147","author":"Ostadal","year":"2023","journal-title":"Circulation"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1161\/circulationaha.118.036614","article-title":"Impella support for acute myocardial infarction complicated by cardiogenic shock","volume":"139","author":"Schrage","year":"2019","journal-title":"Circulation"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1638","DOI":"10.1016\/s0140-6736(13)61783-3","article-title":"Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (Iabp-Shock Ii): final 12 month results of a randomised, open-label trial","volume":"382","author":"Thiele","year":"2013","journal-title":"Lancet"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1702","DOI":"10.1002\/ccd.30150","article-title":"Rates and impact of vascular complications in mechanical circulatory support","volume":"99","author":"Lemor","year":"2022","journal-title":"Catheter Cardiovasc Interv"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1287","DOI":"10.1056\/NEJMoa1208410","article-title":"Intraaortic balloon support for myocardial infarction with cardiogenic shock","volume":"367","author":"Thiele","year":"2012","journal-title":"N Engl J Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1016\/j.jacc.2016.10.022","article-title":"Percutaneous mechanical circulatory support versus intra-aortic balloon pump in cardiogenic shock after acute myocardial infarction","volume":"69","author":"Ouweneel","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1056\/NEJMoa2312572","article-title":"Microaxial flow pump or standard care in infarct-related cardiogenic shock","volume":"390","author":"M\u00f8ller","year":"2024","journal-title":"N Engl J Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1056\/nejm199908263410901","article-title":"Early revascularization in acute myocardial infarction complicated by cardiogenic shock. Shock investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock","volume":"341","author":"Hochman","year":"1999","journal-title":". N Engl J Med"},{"key":"B27","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/j.jacc.2015.11.048","article-title":"Post-hospital outcomes of patients with acute myocardial infarction with cardiogenic shock: findings from the NCDR","volume":"67","author":"Shah","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e024932","DOI":"10.1161\/jaha.121.024932","article-title":"Association between the acidemia, lactic acidosis, and shock severity with outcomes in patients with cardiogenic shock","volume":"11","author":"Jentzer","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"B29","doi-asserted-by":"publisher","first-page":"688098","DOI":"10.3389\/fcvm.2021.688098","article-title":"Impact of age on outcomes in patients with cardiogenic shock","volume":"8","author":"Kanwar","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e1051","DOI":"10.1161\/cir.0000000000001214","article-title":"Cardiogenic shock in older adults: a focus on age-associated risks and approach to management: a scientific statement from the American heart association","volume":"149","author":"Blumer","year":"2024","journal-title":"Circulation"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1538395\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T01:24:34Z","timestamp":1745889874000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1538395\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,29]]},"references-count":30,"alternative-id":["10.3389\/fcvm.2025.1538395"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1538395","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2024.11.14.24317361","asserted-by":"object"}]},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,29]]},"article-number":"1538395"}}