Department of Emergency Medicine, Balıkesir University Faculty of Medicine, Balıkesir, Turkey.
Department of Emergency Medicine, Balıkesir University Faculty of Medicine, Balıkesir, Turkey.
Am J Emerg Med. 2021 Sep;47:274-278. doi: 10.1016/j.ajem.2021.05.008. Epub 2021 May 4.
This study aimed to make a comparison between classical shock index (SI), modified shock index (MSI), and age shock index (age SI) for predicting critical patients presenting to the emergency department (ED) with gastrointestinal bleeding (GIS).
The study, which was planned retrospectively, consisted of patients diagnosed with GIS bleeding at the ED admission. Triage time vital signs were used to calculate SI, MSI, and age SI. These results were compared with intensive care admission, endoscopic/colonoscopic (E/C) intervention, blood transfusion, and mortality criteria, which we define as adverse outcomes.
The study included 151 patients. Seventy-nine (52.32%) of the patients had at least one adverse outcome. Of the 151 patients, 19 (12.58%) had ICU admission, 27 (17.88%) underwent endoscopic/colonoscopic (E/C) intervention, 68 (45.03%) received a blood transfusion, and 6 (3.97%) died. There was a significant difference between patients who had no adverse outcome and those who had at least one adverse outcome in terms of SI, age SI, and MSI. We performed ROC curve analyses to evaluate the diagnostic performances of all indices for predicting adverse outcomes. AUC (area under the curve) values for age SI was the highest (age SI AUC = 0.711, p < 0.001; SI AUC = 0.616; MSI AUC = 0.617). The performance of the age SI was significantly higher than the SI (p = 0.013) and the MSI (p = 0.024) for predicting adverse outcomes. The cut-off value for the age shock index was 45.12.
In patients with GIS bleeding, age SI, which can be easily calculated in triage, is more significant than SI and MSI for predicting the critical patient.
本研究旨在比较经典休克指数（SI）、改良休克指数（MSI）和年龄休克指数（age SI）在预测因胃肠道出血（GIS）就诊于急诊科（ED）的危急患者方面的作用。
本回顾性研究纳入了 ED 入院时诊断为 GIS 出血的患者。使用分诊时的生命体征来计算 SI、MSI 和 age SI。将这些结果与重症监护病房（ICU）收治、内镜/结肠镜（E/C）干预、输血和死亡率标准（我们定义为不良结局）进行比较。
该研究共纳入 151 例患者。其中 79 例（52.32%）患者至少出现一种不良结局。151 例患者中，19 例（12.58%）患者收入 ICU，27 例（17.88%）接受了内镜/结肠镜（E/C）干预，68 例（45.03%）患者接受了输血，6 例（3.97%）患者死亡。无不良结局患者与至少出现一种不良结局患者在 SI、age SI 和 MSI 方面存在显著差异。我们进行了 ROC 曲线分析，以评估所有指标预测不良结局的诊断性能。age SI 的 AUC（曲线下面积）值最高（age SI AUC = 0.711，p < 0.001；SI AUC = 0.616；MSI AUC = 0.617）。age SI 对预测不良结局的表现明显优于 SI（p = 0.013）和 MSI（p = 0.024）。age 休克指数的截断值为 45.12。
在 GIS 出血患者中，age SI 可在分诊时简便计算，其预测危急患者的能力优于 SI 和 MSI。
