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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
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
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