Jentzer Jacob C, Rayfield Corbin, Soussi Sabri, Berg David D, Kennedy Jason N, Sinha Shashank S, Baran David A, Brant Emily, Mebazaa Alexandre, Billia Filio, Kapur Navin K, Henry Timothy D, Lawler Patrick R
Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA.
Department of Cardiovascular Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA.
JACC Adv. 2022 Oct 28;1(4):100120. doi: 10.1016/j.jacadv.2022.100120. eCollection 2022 Oct.
Cardiogenic shock (CS) is a heterogeneous syndrome reflecting a broad spectrum of shock severity, diverse etiologies, variable cardiac function, different hemodynamic trajectories, and concomitant organ dysfunction. These factors influence the clinical presentation, management, response to therapy, and outcomes of CS patients, necessitating a tailored approach to care. To better understand the variability inherent to CS populations, recent algorithms for staging the severity of CS have been described and validated. This paper is part 1 of a 2-part state-of-the-art review. In this first article, we consider the context for clinical staging and stratification in CS with a focus on established severity staging systems for CS and their use for risk stratification and clinical care. We describe the use of staging for predicting outcomes in populations with or at risk for CS, including risk modifiers that provide more nuanced risk stratification, and highlight how these approaches may allow individualized care.
心源性休克(CS)是一种异质性综合征,反映了休克严重程度的广泛范围、多种病因、可变的心脏功能、不同的血流动力学轨迹以及伴随的器官功能障碍。这些因素影响CS患者的临床表现、管理、对治疗的反应和预后,因此需要采取个性化的护理方法。为了更好地理解CS人群固有的变异性,最近已经描述并验证了用于对CS严重程度进行分期的算法。本文是一篇分为两部分的最新综述的第1部分。在这第一篇文章中,我们考虑CS临床分期和分层的背景,重点关注已确立的CS严重程度分期系统及其在风险分层和临床护理中的应用。我们描述了分期在预测CS患者或有CS风险人群预后方面的应用,包括提供更细致风险分层的风险修正因素,并强调这些方法如何实现个性化护理。