Utility of Shock Indexes in Predicting Early Results of Septic Shock Patients in Intensive Care Unit

Abstract

Objectives: Some parameters are currently being used in Intensive Care Units (ICU) in order to predict the mortality. In our study, we aimed to determine the usability of shock index (SI), modified shock index (MSI) and age shock index (ASI) in order to predict the clinical outcomes and mortality of patients with sepsis and septic shock. Study Design: We retrospectively evaluated the results of patients who were hospitalized in ICU, between January 1, 2018 and December 31, 2018. Patients and Methods: Age, gender, co-morbidities, acute physiology and chronic health evaluation II (APACHE II) scores, length of mechanical ventilation, length of hospital stay, SI, MSI, ASI and mortalitywere recorded in patients with sepsis.. Results:We evaluated 172 patients with sepsis. SI, MSI, ASI levels were significantly higher in patients with mortality (p < 0.05). For SI, the area under the receiver operating characteristic (ROC) curve was 0.649 (95% CI = 0.573–0.720, p = 0.0003) and cutoff value for shock index was 1.06 (sensitivity: 62%, 95% CI: 51-72.3; specificity: 67.44%, 95% CI: 56.5-77.2). For MSI, the area under the ROC curve was 0.585 (95% CI = 0.508–0.659, p = 0.049) and cutoff value was 1.69 (sensitivity: 37.9%, 95% CI: 27.7-49; specificity: 82.5%, 95% CI: 72.9-89.9). For ASI, the area under the ROC curve was 0.613 (95% CI = 0.536–0.686, p = 0.0078) and cutoff value was 87.42 (sensitivity: 40.2%, 95% CI: 29.9–51.3; specificity: 82.56%, 95% CI: 72.9–89.9). Conclusion: The shock indexes were found out to be significant in predicting mortality in septic patients. While the sensitivity was limited in 3 shock indexes, specificity was determined significantly higher in ASI and MSI with significantly lower in SI.