Shock index and modified shock index as triage screening tools for sepsis

Althunayyan, Saqer M; Alsofayan, Yousef M.; Khan, Anas

doi:10.1016/j.jiph.2019.05.002

Cited by 25 publications

(22 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with SBP > 100 mmHg at triage and with high delta SI present higher incidence of early mortality after ICU admission. This is consistent with previous studies that revealed that SI may be a predictor of mortality (31,32) in critically ill patients. Since mortality in patients with shock with hypoperfusion remains high, as reported previously ( 19), we offer a more robust dynamic index to ensure that early intervention and management are available to these critically ill patients.…”

Section: Discussionsupporting

confidence: 93%

“…Concerning the stratified analysis per diagnoses, we found that high delta SI in patients with sepsis is correlated with high mortality and early mortality. This corroborates the results of previous studies on the association between high SI and outcome in septic patients (12,32). Similar results were not found for patients with diagnoses of respiratory failure or heart failure.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Delta Shock Index During Emergency Department Stay Is Associated With in Hospital Mortality in Critically Ill Patients

et al. 2021

View full text Add to dashboard Cite

Background: Delta shock index (SI; i.e., change in SI over time) has been shown to predict mortality and need for surgical intervention among trauma patients at the emergency department (ED). However, the usefulness of delta SI for prognosis assessment in non-traumatic critically ill patients at the ED remains unknown. The aim of this study was to analyze the association between delta SI during ED management and in-hospital outcomes in patients admitted to the intensive care unit (ICU).Method: This was a retrospective study conducted in two tertiary medical centers in Taiwan from January 1, 2016, to December 31, 2017. All adult non-traumatic patients who visited the ED and who were subsequently admitted to the ICU were included. We calculated delta SI by subtracting SI at ICU admission from SI at ED triage, and we analyzed its association with in-hospital outcomes. SI was defined as the ratio of heart rate to systolic blood pressure (SBP). The primary outcome was in-hospital mortality, and the secondary outcomes were hospital length of stay (HLOS) and early mortality. Early mortality was defined as mortality within 48 h of ICU admission.Result: During the study period, 11,268 patients met the criteria and were included. Their mean age was 64.5 ± 15.9 years old. Overall, 5,830 (51.6%) patients had positive delta SI. Factors associated with a positive delta SI were multiple comorbidities (51.2% vs. 46.3%, p < 0.001) and high Simplified Acute Physiology Score [39 (29–51) vs. 37 (28–47), p < 0.001). Patients with positive delta SI were more likely to have tachycardia, hypotension, and higher SI at ICU admission. In the regression analysis, high delta SI was associated with in-hospital mortality [aOR (95% CI): 1.21 (1.03–1.42)] and early mortality [aOR (95% CI): 1.26 (1.07–1.48)], but not for HLOS [difference (95% CI): 0.34 (−0.48 to 1.17)]. In the subgroup analysis, high delta SI had higher odds ratios for both mortality and early mortality in elderly [aOR (95% CI): 1.59 (1.11–2.29)] and septic patients [aOR (95% CI): 1.54 (1.13–2.11)]. It also showed a higher odds ratio for early mortality in patients with triage SBP <100 mmHg [aOR (95% CI): 2.14 (1.21–3.77)] and patients with triage SI ≥ 0.9 [aOR (95% CI): 1.62 (1.01–2.60)].Conclusion: High delta SI during ED stay is correlated with in-hospital mortality and early mortality in patients admitted to the ICU via ED. Prompt resuscitation should be performed, especially for those with old age, sepsis, triage SBP <100 mmHg, or triage SI ≥ 0.9.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Delta Shock Index During Emergency Department Stay Is Associated With in Hospital Mortality in Critically Ill Patients

et al. 2021

View full text Add to dashboard Cite

show abstract

“…It basically consists of heart rate/systolic blood pressure value (2). Although it was first used to determine the degree of hypovolemia in cases of hemorrhagic and septic shock, today it is also used as an assessment scale in all types of systemic conditions in which tissue perfusion is impaired (3)(4)(5)(6). SI has been found to have a particularly strong association with the left ventricular stroke volume and cardiac output (2).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the ability of the shock index, modified shock index and age shock index to predict mortality in geriatric patients with COVID-19 pneumonia

Tekyol

Hökenek

2021

Journal of Health Sciences and Medicine

View full text Add to dashboard Cite

show abstract

“…A review of the National Trauma Data Bank supported data that the shock index was a useful predictor of morbidity and mortality in geriatric trauma patients [7]. While several studies were done in trauma patients and the principles could theoretically be applied to those in other types of shock, only a few other studies have been done to assess all patients presenting to the Emergency Department (ED) to identify high-risk septic patients using the SI and lactate levels [8][9]. A study by Kaukonen et al demonstrated that SI ≥ 1.0 correlated with the most specific predictor for mortality and high lactate levels [8].…”

mentioning

confidence: 99%

“…A study by Kaukonen et al demonstrated that SI ≥ 1.0 correlated with the most specific predictor for mortality and high lactate levels [8]. Another study showed that patients with SI ≥ 0.7 were more likely to have sepsis hyperlactatemia, intensive care unit (ICU) admission, and mortality [9]. Both of these studies included only patients presenting to the ED.…”

mentioning

confidence: 99%

Shock Index as a Marker for Mortality Rates in Those Admitted to the Medical Intensive Care Unit from the Emergency Department

Sahu

Yee

Das

et al. 2020

Cureus

View full text Add to dashboard Cite

Objective Shock index (SI) is defined as the heart rate divided by systolic blood pressure. Studies have shown a correlation between the shock index and mortality in trauma patients in prehospital settings and in the emergency department (ED). The objective of this study was to identify the utility of SI in predicting mortality in the medical intensive care unit (MICU) patients admitted from the ED and transfers from the floor to MICU. Design We performed a retrospective analysis of adult patients admitted to the MICU at our urban trauma hospital between January 2015 through August 2015 using ED vital signs to calculate the shock index and identify inpatient deaths. Similar data were examined for inpatient transfers to the MICU. Results Nine hundred and fifty patients were included in the study; 743 had an SI ≤ 0.99 with a mortality rate of 15.9%. Two hundred and seven patients had a SI ≥ 1.00 with a mortality rate of 22.7%. A higher SI was significant for mortality. There was no statistical significance in SI and mortality rate for patients transferred from the medical floor to the ICU. Conclusions Patients with an SI ≥ 1.00 from initial ED vital signs correlated with a higher mortality rate. In patients transferred from the floor to MICU, SI ≥ 1.00 did not correlate with a higher mortality rate.

show abstract

Shock index and modified shock index as triage screening tools for sepsis

Cited by 25 publications

References 30 publications

Delta Shock Index During Emergency Department Stay Is Associated With in Hospital Mortality in Critically Ill Patients

Delta Shock Index During Emergency Department Stay Is Associated With in Hospital Mortality in Critically Ill Patients

Comparison of the ability of the shock index, modified shock index and age shock index to predict mortality in geriatric patients with COVID-19 pneumonia

Shock Index as a Marker for Mortality Rates in Those Admitted to the Medical Intensive Care Unit from the Emergency Department

Contact Info

Product

Resources

About