FLAG score predicts circulatory support need in shock

Prehospital prediction of mechanical circulatory support during hospital stay in cardiogenic shock: The FLAG score
Heart & Lung · Added 27 July 2026

The FLAG risk score is a simple, registry-based model to predict MCS treatment during hospital stay in a prehospital setting.

Study type: Cohort
Design: Retrospective registry-based risk score development study
Participants: 431 prehospital patients with cardiogenic shock at two German university hospitals
Main finding: MCS implanted in 34.3%; FLAG score (fibrinolysis, CPR ≥35 min, age ≥65, female) predicted MCS with AUROC 0.707 in internal validation; predicted risk 16.9% to 83.1%
Caveat: Retrospective derivation with only internal validation, modest AUROC, no external validation
Bottom line: Hypothesis-generating

Learning goal

Weigh which patients with cardiogenic shock need early escalation to mechanical circulatory support.

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