Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Wang, Guoyu; Wang, Ruzhu; Liu, Ling; Wang, Jing; Zhou, Lei

doi:10.1177/03000605211000506

Cited by 7 publications

(8 citation statements)

References 39 publications

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“…Prior studies have demonstrated the prognostic utility of SI in patients with individual cardiac pathologies, including ACS, heart failure, and cardiogenic shock [ 31 – 35 ]. SI alone was shown to perform as well as the GRACE risk score in patients with ACS, with the advantage of being easier to calculate [ 36 – 38 ]. Notably, both HR and SBP are included in the GRACE risk score [ 7 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

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Association between the shock index on admission and in-hospital mortality in the cardiac intensive care unit

Padkins,

Kashani,

Tabi

et al. 2024

PLoS ONE

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Background An elevated shock index (SI) predicts worse outcomes in multiple clinical arenas. We aimed to determine whether the SI can aid in mortality risk stratification in unselected cardiac intensive care unit patients. Methods We included admissions to the Mayo Clinic from 2007 to 2015 and stratified them based on admission SI. The primary outcome was in-hospital mortality, and predictors of in-hospital mortality were analyzed using multivariable logistic regression. Results We included 9,939 unique cardiac intensive care unit patients with available data for SI. Patients were grouped by SI as follows: < 0.6, 3,973 (40%); 0.6–0.99, 4,810 (48%); and ≥ 1.0, 1,156 (12%). After multivariable adjustment, both heart rate (adjusted OR 1.06 per 10 beats per minute higher; CI 1.02–1.10; p-value 0.005) and systolic blood pressure (adjusted OR 0.94 per 10 mmHg higher; CI 0.90–0.97; p-value < 0.001) remained associated with higher in-hospital mortality. As SI increased there was an incremental increase in in-hospital mortality (adjusted OR 1.07 per 0.1 beats per minute/mmHg higher, CI 1.04–1.10, p-Value < 0.001). A higher SI was associated with increased mortality across all examined admission diagnoses. Conclusion The SI is a simple and universally available bedside marker that can be used at the time of admission to predict in-hospital mortality in cardiac intensive care unit patients.

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Section: Discussionmentioning

confidence: 99%

“…shown to perform as well as the GRACE risk score in patients with ACS, with the advantage of being easier to calculate [36][37][38]. Notably, both HR and SBP are included in the GRACE risk score [7,39].…”

Section: Plos Onementioning

confidence: 96%

Association between the shock index on admission and in-hospital mortality in the cardiac intensive care unit

Padkins,

Kashani,

Tabi

et al. 2024

PLoS ONE

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“…Multivariate analysis shows that high SI (and its derivatives) values are associated with higher complication rates. 19 Renal dysfunction is believed to be a risk factor for mortality in patients with myocardial infarction. 4 Cywinski et al showed that estimated renal function was a better prognostic indicator than Scr.…”

Section: Discussionmentioning

confidence: 99%

Shock Index Creatinine: A New Predictor of Mortality in Acute Coronary Syndrome Patients

Shariefuddin

Pramudyo

Martha

2023

Preprint

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Background The Shock Index Creatinine (SIC) scoring is a recently developed tool for risk stratification patients. These updated scoring was already used in ST-Elevation Myocardial Infarction (STEMI) patients. However its utility in predicting outcomes for patients with Acute Coronary Syndrome (ACS) remains unclear. This study aims to evaluate and update the current SIC score to predict in-hospital mortality among patients with ACS.Patients and methods: A retrospective cohort, Single-centered study enrolled 1393 ACS patients aged ≥ 18 years old diagnosed with ACS was conducted between January 2018 to January 2022. Study subjects were analyzed for in-hospital mortality and evaluated using binary linear regression analysis. The area under the curve (AUC) of SIC score was obtain to predict the sensitivity and specificity.Results Multivariate analysis showed that SIC score was significantly associated with in-hospital mortality. High SIC score (SIC ≥ 25) had significantly higher in-hospital mortality (p < 0.001) with odds ratio for (95% CIs) were 2.655 (1.6–4.31). Receiver operating characteristics (ROC) curve analysis determine the predictive power of SIC score for in-hospital mortality. SIC had an acceptable predictive value for in-hospital mortality (AUC = 0.789, 95% CI: 0.748–0.831, p < 0.001). The SIC score for sensitivity and specificity were, respectively, 71.5% and 74.4%, with optimal cutoff of SIC ≥ 25.Conclusion SIC had acceptable predictive value for in-hospital mortality in patients with all ACS spectrums. SIC was a useful parameter for predicting in-hospital mortality, particularly with a score ≥ 25. This is the first study to evaluate SIC in all spectrums of ACS.

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“…Although evaluation of SI derivatives is less frequently investigated in HF, there are several records that assessed the utility of these indices in acute coronary syndrome (ACS), especially myocardial infarction (MI) patients. 29 - 32 A study on 24 636 subjects suffered from ACS with optimal SI cut-off point of 0.80 showed patients who had higher values experienced 3.40 times (95% CI: 2.29-5.02, P < .001) increased chance of in-hospital death compared to those with lower SI ranges. 33 …”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Shock Index, Modified Shock Index, and Age-Adjusted Derivatives in Prediction of In-Hospital Mortality in Patients with Acute Decompensated Heart Failure: Persian Registry of Cardiovascular Disease/ Heart Failure Study

Bondariyan

Vakhshoori

Sadeghpour

et al. 2022

Anatolian J Cardiol

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Background Introduction of simple bedside tools for assessing patients’ condition in different settings improves triaging. However, these indices are less frequently used in heart failure. This study aims to evaluate the utility of shock index, age shock index, modified shock index, and age-modified shock index in the prediction of in-hospital mortality in acute decompensated heart failure individuals. Methods We conducted this retrospective study on 3652 acute decompensated heart failure individuals in the context of Persian Registry of Cardiovascular Disease/heart failure. Shock index, age shock index, modified shock index, and age-modified shock index were assessed during admission. Receiver operating characteristic curve was used to define the optimum cut-off point. Odds ratio models were used for investigating the association of in-hospital mortality according to each specified cut-off value. Results Mean age was 70.12 ± 12.56 years (males: 62.6%). Optimum cut-off point for shock index, age shock index, modified shock index, and age-modified shock index were set to be 0.71 (sensitivity: 63%, specificity: 60%), 50.5 (sensitivity: 65%, specificity: 60%), 0.94 (sensitivity: 60%, specificity: 60%), and 66.7 (sensitivity: 62%, specificity: 60%), respectively. Participants with higher shock index derivatives in all domains had significantly higher likelihood of death. Compared to those with shock index, age shock index, modified shock index, and age-modified shock index values of less than cut-off points, adjusted model revealed patients with higher values had 2.59 (95% CI: 1.94-3.46, P < .001), 2.61 (95% CI: 1.95-3.48, P < .001), 2.14 (95% CI: 1.61-2.84, P < .001), and 2.28 (95% CI: 1.72-3.03, P < .001) times increase in-hospital death risk, respectively. Conclusions Shock index, age shock index, modified shock index, and age-modified shock index are simple bedside tools to reliably predict in-hospital mortality in acute decompensated heart failure patients to better prioritize high-risk subjects.

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Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Cited by 7 publications

References 39 publications

Association between the shock index on admission and in-hospital mortality in the cardiac intensive care unit

Association between the shock index on admission and in-hospital mortality in the cardiac intensive care unit

Shock Index Creatinine: A New Predictor of Mortality in Acute Coronary Syndrome Patients

Prognostic Value of Shock Index, Modified Shock Index, and Age-Adjusted Derivatives in Prediction of In-Hospital Mortality in Patients with Acute Decompensated Heart Failure: Persian Registry of Cardiovascular Disease/ Heart Failure Study

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