SHOCK Score: Explanation and Clinical Context The SHOCK Score was developed from the SHOCK Trial Registry to predict short-term mortality among patients presenting with cardiogenic shock following acute myocardial infarction. This score integrates seven readily available clinical variables: age > 75 years, female gender, anterior myocardial infarction, previous MI, serum creatinine > 1.9 mg/dL, altered mental status, and systolic blood pressure < 90 mmHg at presentation.
Each variable contributes one point, producing a total score ranging from 0 to 7. The cumulative score stratifies patients into low (0–1), intermediate (2–3), and high (>4) risk categories, correlating strongly with 30-day mortality rates observed in the SHOCK Trial Registry — approximately 30%, 50%, and 80–90%, respectively.
Clinically, the SHOCK Score serves as a valuable bedside tool to assist in early prognostic assessment and therapeutic decision-making, especially regarding advanced mechanical support (IABP, Impella, ECMO) or early revascularization strategies. It is important to note that this model was specifically validated for cardiogenic shock secondary to myocardial infarction and may not apply to shock from other etiologies such as myocarditis or advanced heart failure.
Reference:
Sleeper LA, et al. The SHOCK Trial Registry: Development and validation of a predictive risk model for mortality in cardiogenic shock. J Am Coll Cardiol. 2000;36(3 Suppl A):1076–1083.
Hochman JS, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Engl J Med. 1999;341:625–634.