MIS-C Cardiac Severity Index (Cardiogenic Shock Risk) Calculator

MIS-C Cardiac Severity Index (Cardiogenic Shock Risk) Calculator MIS-C Cardiac Severity Index (Cardiogenic Shock Risk): Explanation and Clinical Context This calculator applies a validated multivariable model designed to predict cardiogenic shock in children with Multisystem Inflammatory Syndrome (MIS-C). The score is computed as: 0.128 × Age (years) + 1.195 × Dyspnea (1 if present) + 0.007 × CRP (mg/L) − 2.6732. A threshold of −0.4761 distinguishes high- from low-risk patients at diagnosis.

In validation studies, higher scores were associated with lower minimal left ventricular ejection fraction (LVEF), supporting its role in early cardiac severity stratification. Intended Use: The tool aids clinicians in risk stratification at MIS-C presentation. It complements—not replaces—clinical judgment, echocardiographic assessment, and biomarker evaluation.

Children with high-risk scores should receive early cardiac imaging, fluid optimization, and consideration of vasoactive support per institutional MIS-C guidelines. Model Provenance: Derived from a multicenter pediatric cohort (Bichali et al., 2025), this model integrates age, CRP, and dyspnea to predict early cardiac decompensation. Its predictive accuracy supports bedside implementation for rapid triage, especially in settings with delayed echocardiographic access.

Clinical Significance: High scores correlate with increased likelihood of left ventricular dysfunction, myocardial strain, and the need for inotropes. Ongoing reassessment is warranted as MIS-C patients can deteriorate rapidly, and biomarker trends (NT-proBNP, troponin, D-dimer) provide additional context.