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Circulation: Cardiovascular Imaging EDITORIAL Is Left Ventricular Stroke Work Index Useful in the Cardiac Intensive Care Unit? See Article by Jentzer et al Katherine A.A. Clark, MD, MBA Robert L. McNamara , atient care in cardiac intensive care units (CICUs) has become increasingly MD, MHS complex over time, as patients have more comorbidities, and clinicians have 1,2 Pmore numerous pharmacological and mechanical interventions. Despite the increasing complexity, the cardiac critical care literature provides limited data to pre- dict outcomes once patients are admitted to the CICU. Comparatively, medical ICU providers have numerous tools at hand to risk stratify patients, none of which are particularly relevant for the care of cardiac ICU patients. Even the most comprehen- sive tool, the Acute Physiology and Chronic Health Evaluation-IV score was devel- oped about 20 years ago and with only 16% cardiac patients. A few scoring models have been validated for use in the CICU, but clinicians have yet to routinely rely upon 1–4 them. Although Acute Physiology and Chronic Health Evaluation-IV was found to have better discrimination in predicting mortality, it is a cumbersome model, even when automated, as it incorporates 142 variables. Notably, in this model, normal values are used in
Circulation: Cardiovascular Imaging – Wolters Kluwer Health
Published: Nov 1, 2020
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