Value of shock index in the prognosis of early severe sepsis and septic shock in the emergency department

Abstract

Objective To explore the significance of shock index in the early assessment of patients with severe sepsis and septic shock. Methods A retrospective study of 100 patients with severe sepsis and septic shock admitted in the Emergency Department of the Beijing Friendship Hospital from September 2011 to August 2013 was carried out. According to the 28-day outcome, all patients were divided into survival group (n =48) and death group (n =52) . Shock index of patients was calculated at admission (SI1) and 2 hours after resuscitation (SI 2) . Results (1) The SI1 and SI2 (1.5±0.05) , (1.2±0.04) in the death group were significantly higher than those (1.3±0.08) , (0.9±0.05) ,in the survival group (P< 0.01) ; (2) AUC of SI1 and SI2 of death group were 0.7075 and 0.8894, respectively. The SI2 showed higher sensitivity (80.3%) and specificity (78.4%) compared to SI1. The optimal cut-off point for SI2 was ≥ 1. Conclusions SI2 may potentially be utilized as a reliable predictor for death in patients with septic shock and severe sepsis in an emergency department. Key words: Sepsis; Severe sepsis; Septic shock; Shock index; Sensitivity; Specificity; Prognosis; Assessment