AUTHOR=Fang Dingfeng , Chen Huihe , Geng Hui , Chen Xiahuan , Liu Meilin 

TITLE=Development and validation of a nomogram for predicting survival in patients with cardiogenic shock

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1538395

DOI=10.3389/fcvm.2025.1538395

ISSN=2297-055X

ABSTRACT=BackgroundThere 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.Methods and resultsThe 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: 0.73–0.77) in the training cohort and 0.73 (95% CI: 0.70–0.77) 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, P < 0.01 by Delong test). Subgroup analysis confirmed the model's robustness across both AMI-CS and non-AMI-CS subgroups.ConclusionsThe 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.