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The Usefulness of Shock Index and Modified Shock Index in Predicting the Outcome of COVID-19 Patients

Published online by Cambridge University Press:  08 June 2021

Erdem Kurt*
Affiliation:
Department of Emergency Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
Suphi Bahadirli
Affiliation:
Department of Emergency Medicine, Beylikduzu State Hospital, Istanbul, Turkey
*
Corresponding Author: Erdem Kurt, Email: erdemkurt8@gmail.com.

Abstract

Objective:

The aim of this study is to investigate the accuracy of shock index (SI) and modified shock index (mSI) in predicting the intensive care unit (ICU) requirement and in-hospital mortality among coronavirus disease (COVID-19) patients who are admitted to the emergency department (ED). Likewise, the effects of patients’ conditions such as age, gender, and comorbidity on prognosis will be analyzed.

Methods:

The files were retrospectively scanned for all COVID-19 patients over the age of 18 years who were admitted to the ED and hospitalized between January 1, 2021, and March 15, 2021. The area under the receiver operating characteristic curve and the area under the curve (AUC) were used to assess each scoring system discriminatory for predicting in-hospital mortality and ICU admission.

Results:

There were 464 patients included in this study. The mean age of the patients was 62.4 ± 16.7, of which 245 were men and 219 were women. The most common comorbidity in patients was hypertension (200; 43.1%), followed by chronic obstructive pulmonary disease (174; 37.5%), and coronary artery disease (154; 33.2%). In terms of in-hospital mortality, the AUC of SI, and mSI were 0.719 and 0.739, respectively. In terms of an ICU requirement, the AUC of SI, and mSI were 0.704 and 0.729, respectively.

Conclusion:

In this study, it was concluded that SI and mSI are useful in predicting in-hospital mortality and ICU requirement in COVID-19 patients. In addition, another important result of the study is that advanced age, male gender, and hypertension may be associated with a poor prognosis.

Type
Original Research
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

Huang, C, Wang, Y, Li, X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.Google ScholarPubMed
Grasselli, G, Pesenti, A, Cecconi, M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA. 2020;323(16):1545-1546.Google ScholarPubMed
Worldometer. COVID-19: Coronavirus pandemic. https://www.worldometers.info/coronavirus/. Accessed April 17, 2021.Google Scholar
Ciceri, F, Castagna, A, Rovere-Querini, P, et al. Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy. Clin Immunol. 2020;217:108509.Google ScholarPubMed
Phua, J, Weng, L, Ling, L, et al.; and Asian Critical Care Clinical Trials Group. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. Lancet Respir Med. 2020;8(5):506-517.Google ScholarPubMed
Allgöwer, M, Schockindex, Burri C.. Dtsch Med Wochenschr. 1967;92(43):1947-1950.CrossRefGoogle Scholar
Liu, YC, Liu, JH, Fang, ZA, et al. Modified shock index and mortality rate of emergency patients. World J Emerg Med. 2012;3(2):114.CrossRefGoogle ScholarPubMed
Guan, WJ, Ni, ZY, Hu, Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708-1720. doi: 10.1056/NEJMoa2002032.Google ScholarPubMed
Wei, X, Xiao YT, Wang J, et al. Sex differences in severity and mortality among patients with COVID-19: evidence from pooled literature analysis and insights from integrated bioinformatic analysis. arXiv preprint, arXiv. 2020;2003.13547.Google Scholar
Cai, H. Sex difference and smoking predisposition in patients with COVID-19.Lancet Respir Med. 2020;8(4):e20.Google ScholarPubMed
Stokes, EK, Zambrano, LD, Anderson, KN, et al. Coronavirus disease 2019 case surveillance – United States, January 22–May 30, 2020. Morb Mortal Wkly Rep. 2020;69(24):759.CrossRefGoogle ScholarPubMed
Du, RH, Liang, LR, Yang, CQ. Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. Eur Respir J. 2020;55(5).Google Scholar
Opal, SM, Girard, TD, Ely, EW. The immunopathogenesis of sepsis in elderly patients. Clin Infect Dis. 2005;41(Suppl 7):S504-S512.CrossRefGoogle ScholarPubMed
Richardson, S, Hirsch, JS, Narasimhan, M, et al. (2020). Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020;323(20):2052-2059.CrossRefGoogle ScholarPubMed
Guzik, TJ, Mohiddin, SA, Dimarco, A, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020;116(10):1666-1687.Google ScholarPubMed
Olaussen, A, Blackburn, T, Mitra, B, Fitzgerald, M. Shock index for prediction of critical bleeding post-trauma: a systematic review. Emerg Med Australas. 2014;26(3):223-228.Google ScholarPubMed
Al Jalbout, N, Balhara, KS, Hamade, B, et al. Shock index as a predictor of hospital admission and inpatient mortality in a US national database of emergency departments. Emerg Med J. 2019;36(5):293-297.Google Scholar
Cannon, CM, Braxton, CC, Kling-Smith, M, et al. Utility of the shock index in predicting mortality in traumatically injured patients. J Trauma Acute Care Surg. 2009;67(6):1426-1430.CrossRefGoogle ScholarPubMed
Doğanay, F, Elkonca, F, Seyhan, AU, et al. Shock index as a predictor of mortality among the COVID-19 patients. Am J Emerg Med. 2021;40:106-109.Google ScholarPubMed