Modified Shock Index as a Predictor of Admission and In hospital Mortality in Emergency Departments, an Analysis of a US National Database

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Hamade Bachar; Bayram Jamil D.; Hsieh Yu Hsiang; Khishfe Basem; Al Jalbout Nour

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Journal: Archives of Academic Emergency Medicine Year:621 | Volume: | Issue: Page(s): 0-0

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Title

Modified Shock Index as a Predictor of Admission and In hospital Mortality in Emergency Departments, an Analysis of a US National Database

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Keywords

Modified shock index

Hospitalization

Inpatients

HospitalMortality

Emergency Service

Hospital

Probability

Abstract

Introduction: The Modified shock index (MSI) is the ratio of heart rate to mean arterial pressure. It is used as a predictive and prognostic marker in a variety of disease states. This study aimed to derive the optimal MSI cut-off that is associated with increased likelihood (likelihood ratio, LR) of admission and in-Hospital mortality in patients presenting to emergency department (ED). Methods: We retrospectively reviewed data fromthe National Hospital Ambulatory Medical Care Survey between 2005 and 2010. Adults>18 years of age were included regardless of chief complaint. Basic patient demographics, initial vital signs, and outcomes were recorded for each patient. Then the optimal MSI cut-off for prediction of admission and in-Hospital mortality in ED was calculated. LR ¸,5 was considered clinically significant. Results: 567, 994, 402 distinct weighted adult ED patient visits were included in the analysis. 15. 7% and 2. 4% resulted in admissions and in-Hospital mortality, respectively. MSI > 1. 7 was associated with a moderate increase in the likelihood of both admission (Positive LR (+LR) = 6. 29) and in-Hospital mortality (+LR = 5. 12). +LR for Hospital admission at MSI >1. 7 was higher for men (7. 13,95% CI 7. 11-7. 15) compared to women (5. 49,95% CI 5. 47-5. 50) and for non-white (7. 92,95% CI 7. 88-7. 95) compared to white patients (5. 85,95% CI 5. 84-5. 86). For MSI <0. 7, the +LRs were not clinically significant for admission (+LR = 1. 07) or in-Hospital mortality (LR = 0. 75). Conclusion: In this largest retrospective study, to date, on MSI in the undifferentiated ED population, we demonstrated that an MSI >1. 7 on presentation is predictive of admission and in-Hospital mortality. The use of MSI could help guide accurate acuity designation, resource allocation, and disposition.

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APA: Copy

Hamade, Bachar, Bayram, Jamil D., Hsieh, Yu Hsiang, Khishfe, Basem, & Al Jalbout, Nour. (2023). Modified Shock Index as a Predictor of Admission and In hospital Mortality in Emergency Departments, an Analysis of a US National Database. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), 11(1), 0-0. SID. https://sid.ir/paper/1115191/en

Vancouver: Copy

Hamade Bachar, Bayram Jamil D., Hsieh Yu Hsiang, Khishfe Basem, Al Jalbout Nour. Modified Shock Index as a Predictor of Admission and In hospital Mortality in Emergency Departments, an Analysis of a US National Database. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY)[Internet]. 2023;11(1):0-0. Available from: https://sid.ir/paper/1115191/en

IEEE: Copy

Bachar Hamade, Jamil D. Bayram, Yu Hsiang Hsieh, Basem Khishfe, and Nour Al Jalbout, “Modified Shock Index as a Predictor of Admission and In hospital Mortality in Emergency Departments, an Analysis of a US National Database,” ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), vol. 11, no. 1, pp. 0–0, 2023, [Online]. Available: https://sid.ir/paper/1115191/en

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