Using the Random Forest (RF) algorithm, we achieved an AUROC of 0.94 (95% confidence interval (CI): 0.90–0.98), an AUPRC of 0.44 (95% CI:0.15–0.76) in the internal validation set, identifying five key predictors: cardiogenic shock, creatinine, NT-proBNP, diastolic blood pressure, and left ventricular ejection fraction. This evidence concerns the gene NPPB and Shock.