Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Anatol J Cardiol. 2022 Mar;26(3):210-217. doi: 10.5152/AnatolJCardiol.2021.671.
Introduction of simple bedside tools for assessing patients' condition in different settings improves triaging. However, these indices are less frequently used in heart failure. This study aims to evaluate the utility of shock index, age shock index, modified shock index, and age-modified shock index in the prediction of in-hospital mortality in acute decompensated heart failure individuals.
We conducted this retrospective study on 3652 acute decompensated heart failure individuals in the context of Persian Registry of Cardiovascular Disease/heart failure. Shock index, age shock index, modified shock index, and age-modified shock index were assessed during admission. Receiver operating characteristic curve was used to define the optimum cut-off point. Odds ratio models were used for investigating the association of in-hospital mortality according to each specified cut-off value.
Mean age was 70.12 ± 12.56 years (males: 62.6%). Optimum cut-off point for shock index, age shock index, modified shock index, and age-modified shock index were set to be 0.71 (sensitivity: 63%, specificity: 60%), 50.5 (sensitivity: 65%, specificity: 60%), 0.94 (sensitivity: 60%, specificity: 60%), and 66.7 (sensitivity: 62%, specificity: 60%), respectively. Participants with higher shock index derivatives in all domains had significantly higher likelihood of death. Compared to those with shock index, age shock index, modified shock index, and age-modified shock index values of less than cut-off points, adjusted model revealed patients with higher values had 2.59 (95% CI: 1.94-3.46, P<.001), 2.61 (95% CI: 1.95-3.48, P <.001), 2.14 (95% CI: 1.61-2.84, P <.001), and 2.28 (95% CI: 1.72- 3.03, P <.001) times increase in-hospital death risk, respectively.
Shock index, age shock index, modified shock index, and age-modified shock index are simple bedside tools to reliably predict in-hospital mortality in acute decompensated heart failure patients to better prioritize high-risk subjects.
在不同环境中引入用于评估患者病情的简单床边工具可改善分诊。然而，这些指标在心力衰竭中使用较少。本研究旨在评估休克指数、年龄休克指数、改良休克指数和年龄改良休克指数在预测急性失代偿性心力衰竭患者住院死亡率中的效用。
我们在波斯心血管疾病/心力衰竭注册研究中对 3652 例急性失代偿性心力衰竭患者进行了回顾性研究。在入院时评估休克指数、年龄休克指数、改良休克指数和年龄改良休克指数。使用接收者操作特征曲线来定义最佳截断点。使用比值比模型根据每个指定的截断值调查住院死亡率的相关性。
平均年龄为 70.12 ± 12.56 岁（男性：62.6%）。休克指数、年龄休克指数、改良休克指数和年龄改良休克指数的最佳截断点分别设定为 0.71（敏感性：63%，特异性：60%）、50.5（敏感性：65%，特异性：60%）、0.94（敏感性：60%，特异性：60%）和 66.7（敏感性：62%，特异性：60%）。所有领域休克指数衍生值较高的患者死亡的可能性明显更高。与休克指数、年龄休克指数、改良休克指数和年龄改良休克指数值低于截断值的患者相比，调整模型显示，值较高的患者住院死亡风险分别增加了 2.59（95%CI：1.94-3.46，P<.001）、2.61（95%CI：1.95-3.48，P<.001）、2.14（95%CI：1.61-2.84，P<.001）和 2.28（95%CI：1.72-3.03，P<.001）倍。
休克指数、年龄休克指数、改良休克指数和年龄改良休克指数是可靠预测急性失代偿性心力衰竭患者住院死亡率的简单床边工具，可更好地确定高危患者。
