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Latest & greatest articles for Shock Index
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ShockIndex Predicts Outcome in Patients with Suspected Sepsis or Community-Acquired Pneumonia: A Systematic Review. To improve outcomes for patients who present to hospital with suspected sepsis, it is necessary to accurately identify those at high risk of adverse outcomes as early and swiftly as possible. To assess the prognostic accuracy of shockindex (heart rate divided by systolic blood pressure) and its modifications in patients with sepsis or community-acquired pneumonia.An electronic (...) search of MEDLINE, EMBASE, Allie and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Open Grey, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (WHO ITRP) was conducted from conception to 26th March 2019. Eligible studies were required to assess the prognostic accuracy of shockindex or its modifications for outcomes of death or requirement for organ support either in sepsis or pneumonia. The methodological
Prehospital shockindex to assess 28-day mortality for septic shock In the prehospital setting, early identification of septic shock (SS) with high risk of mortality aims to initiate early treatments and to decide delivery unit (emergency department (ED) or intensive care unit (ICU)). In this context, there is a need for a prognostic measure of severity and death in order to early detect patients with a higher risk of pejorative evolution. In this study, we describe the association between (...) prehospital shockindex (SI) and mortality at day 28 of patients with SS initially cared for in the prehospital setting by a mobile intensive care unit (MICU).Patients with SS cared for by a MICU between January 2016 and May 2019 were retrospectively analyzed. Using propensity score, the association between SI and mortality was assessed by Odd Ratio (OR) with 95 percent confidence interval [95 CI].One-hundred and fourteen patients among which 78 males (68%) were analysed. The mean age was 71 ± 14 years
Shockindex as a predictor of hospital admission and inpatient mortality in a US national database of emergency departments The shockindex (SI), defined as the ratio of the heart rate (HR) to the systolic blood pressure (BP), is used as a prognostic tool in trauma and in specific disease states. However, there is scarcity of data about the utility of the SI in the general emergency department (ED)population. Our goal was to use a large national database of EDs in the United States (US
Value of variation index of inferior vena cava diameter in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation: a systematic review and meta-analysis Respiratory variations in the inferior vena cava diameter (ΔIVCD) have been studied extensively with respect to their value in predicting fluid responsiveness, but the results are conflicting. The aim of this meta-analysis was to explore the value of ΔIVCD for predicting fluid responsiveness (...) in patients with circulatory shock receiving mechanical ventilation.PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched up to June 2017. The diagnostic OR (DOR), sensitivity, and specificity were calculated. The summary ROC curve was estimated, and the area under the ROC curve (AUROC) was calculated.Overall, 603 patients were included in this review, 324 (53.7%) of whom were fluid-responsive. The cutoff values of ΔIVCD varied across studies, ranging from 8% to 21
The prognostic value of shockindex for the outcomes of acute myocardial infarction patients: A systematic review and meta-analysis. Several studies have revealed that high shockindex (SI) is a risk factor for acute myocardial infarction (AMI) patients. These studies do not give a systematic review in this issue. Therefore, we conducted a systematic review and meta-analysis to determine the effect of high SI on the prognosis of AMI patients.We did a systematic search of PubMed, Embase (...) , and the Cochrane Library, using various combinations of keywords such as "shockindex," "shock-index," "acute myocardial infarction," "ST elevation myocardial infarction," "non-ST segment elevation myocardial infarction," "STEMI," "NSTEMI," "AMI," and "MI" for eligible studies published up to December 23, 2016. The 3 primary outcomes for this analysis were all-cause in-hospital mortality, short-term adverse outcomes, and long-term adverse outcomes.Database searches retrieved 226 citations. Finally, 8 studies
Increased body mass index and adjusted mortality in ICU patients with sepsis or septic shock: a systematic review and meta-analysis. At least 25 % of adults admitted to intensive care units (ICU) in the United States have an overweight, obese or morbidly obese body mass index (BMI). The effect of BMI on adjusted mortality in adults requiring ICU treatment for sepsis is unclear. We performed a systematic review of adjusted all-cause mortality for underweight, overweight, obese and morbidly obese (...) BMIs relative to normal BMI for adults admitted to the ICU with sepsis, severe sepsis, and septic shock.PubMed, the Cochrane Library, and EMBASE electronic databases were searched through November 18, 2015, without language restrictions. We included studies that reported multivariate regression analyses for all-cause mortality using standard BMI categories for adults admitted to the ICU for sepsis, severe sepsis, and septic shock. Articles were selected by consensus among multiple reviewers
Is ShockIndex a Valid Predictor of Mortality in Emergency Department Patients With Hypertension, Diabetes, High Age, or Receipt of beta- or Calcium Channel Blockers? Shockindex is a widely reported tool to identify patients at risk for circulatory collapse. We hypothesize that old age, diabetes, hypertension, and β- or calcium channel blockers weaken the association between shockindex and mortality.This was a cohort study of all first-time emergency department (ED) visits between 1995 (...) and 2011 (n=111,019). We examined whether age 65 years or older, diabetes, hypertension, and use of β- or calcium channel blockers modified the association between shockindex and 30-day mortality.The 30-day mortality was 3.0%. For all patients, with shockindex less than 0.7 as reference, a shockindex of 0.7 to 1 had an adjusted odds ratio (OR) of 2.9 (95% confidence interval [CI] 2.7 to 3.2) for 30-day mortality, whereas shockindex greater than or equal to 1 had an OR of 10.5 (95% CI 9.3 to 11.7
Review article: shockindex for prediction of critical bleeding post-trauma: a systematic review. Early diagnosis of haemorrhagic shock (HS) might be difficult because of compensatory mechanisms. Clinical scoring systems aimed at predicting transfusion needs might assist in early identification of patients with HS. The ShockIndex (SI) - defined as heart rate divided by systolic BP - has been proposed as a simple tool to identify patients with HS. This systematic review discusses the SI's
A simple 5-point scoring system, NaURSE (Na+, Urea, Respiratory Rate and ShockIndex in the Elderly), predicts in-hospital mortality in oldest old the mortality is high in acutely ill oldest old patients. Understanding the prognostic factors which influence mortality will help clinicians make appropriate management decisions.we analysed prospective mortality audit data (November 2008 to January 2009) to identify variables associated with in-patient mortality in oldest old. We selected those (...) and 13.8% died as in-patients. Variables (cut-off values) found to be significantly associated with in-patient mortality were admission sodium (>145 mmol/l), urea (≥14 mmol/l), respiratory rate (>20/min) and shockindex (>1.0): creating a 5-point score (NaURSE: NaURS in the Elderly). The crude mortality rates were 9.5, 19.9, 34.4, 66.7, and 100% for scores 0, 1, 2, 3 and 4, respectively. Using the cut-off point of ≥2, the NaURSE score has a specificity of 87% (83.1-90.3) and sensitivity of 39% (28.5
The shockindex and the simplified PESI for identification of low-risk patients with acute pulmonary embolism We compared the test characteristics of the shockindex (SI) and the simplified pulmonary embolism severity index (sPESI) for predicting 30-day outcomes in a cohort of 1,206 patients with objectively confirmed pulmonary embolism (PE). The primary outcome of the study was all-cause mortality. The secondary outcome was nonfatal symptomatic recurrent venous thromboembolism (VTE
Prognostic value of the shockindex along with transthoracic echocardiography in risk stratification of patients with acute pulmonary embolism The initial clinical presentation and echocardiography have key roles in risk stratification of patients with acute pulmonary embolism (PE). To assess the value of shockindex and echocardiographic abnormalities as predictors of in-hospital complications and mortality, echocardiographic features of 159 patients diagnosed with acute PE were reviewed (...) . A shockindex > or =1, independent of echocardiographic findings, was associated with increased in-hospital mortality. Regardless of shockindex, moderate to severe right ventricular (RV) hypokinesis and a ratio of RV to left ventricular (LV) end-diastolic diameter >1 was significantly associated with in-hospital mortality and demonstrated the best predictive values for short-term outcomes. The sensitivity and negative predictive value of diastolic LV impairment (E/A wave <1), RV hypokinesis, RV/LV >1