ToolsCalculators
Observatoire Regional Breton sur l'Infarctus (ORBI) Risk Score
Estimates the risk of in-hospital cardiogenic shock after primary PCI for STEMI.
Observatoire Regional Breton sur l'Infarctus (ORBI) Risk Score
Age > 70 years
Prior stroke or TIA
Cardiac arrest at presentation
Anterior myocardial infarction
First medical contact-to-PCI delay > 90 minutes
Killip class on admission
Heart rate on admission > 90 bpm
SBP < 125 mmHg and pulse pressure < 45 mmHg
Admission glucose > 10 mmol/L (180 mg/dL)
Left main coronary artery is the culprit lesion
Post-PCI TIMI flow grade < 3
Result0 points
Lower predicted risk of in-hospital cardiogenic shock.
When to use
- Estimating the risk of cardiogenic shock after primary PCI for STEMI to guide monitoring intensity and early mechanical circulatory support planning.
Formula
Sum of: age >70y (2), prior stroke/TIA (2), cardiac arrest at presentation (3), anterior MI (1), first-contact-to-PCI delay >90min (2), Killip class II (2) or III (6), heart rate >90 (3), SBP<125 with pulse pressure <45 mmHg (4), admission glucose >10 mmol/L (3), left main culprit (5), post-PCI TIMI flow <3 (5). Range 0-36.
Pearls and pitfalls
- Derived and validated in a French regional STEMI registry of patients treated with primary PCI.
- Several components (post-PCI TIMI flow, Killip class) are only known after the procedure, so the score characterizes risk rather than guiding the initial reperfusion decision.