CardShock Risk Score: Explanation and Clinical Context The CardShock Risk Score is a validated prognostic tool developed in the multicenter European CardShock Study to estimate short-term (in-hospital) mortality in patients presenting with cardiogenic shock, including both acute coronary syndrome (ACS) and non-ACS aetiologies.
It incorporates seven easily available clinical and laboratory variables at admission: age > 75 years; confusion (altered mental status) at presentation; history of prior myocardial infarction (MI) or coronary artery bypass grafting (CABG); ACS as the cause of shock; left ventricular ejection fraction (LVEF) < 40 %; arterial lactate level (> 2 and > 4 mmol/L); and estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m².
Based on the total score, three risk categories can be identified: low (0-3 points), intermediate (4-5 points) and high (6-9 points) risk—with corresponding observed in-hospital mortality of ~8.7 %, ~36 % and ~77 %, respectively.
Clinically, the tool helps cardiologists and intensivists to stratify patients early, guiding decisions on escalation of therapy such as mechanical circulatory support, intensive monitoring or transfer to higher-level care. Importantly, this score emphasises perfusion markers (lactate), cardiac function (LVEF) and renal impairment (eGFR) alongside simple historical and presentation features. Subsequent external validation confirmed acceptable discrimination (AUC ~0.73) and calibration in real-world cohorts.
Reference:
Harjola VP, Lassus J, Sionis A, Køber L, Tarvasmäki T, Spinar J, et al. Clinical picture and risk prediction of short-term mortality in cardiogenic shock. Eur J Heart Fail. 2015;17(5):501-509. doi:10.1002/ejhf.260