Comparison of the shock index, modified shock index, and age shock index in adult admissions to a tertiary hospital

Background: Multiple variables interact constantly to maintain the hemodynamic status of patients. The shock index (SI), the modified shock index (MSI), and the age shock index (ASI) have been studied in different clinical settings to predict hemodynamic instability and associated outcomes. These indices are calculated from simple hemodynamic parameters, are non-invasive, and represent no additional expense. We wanted to analyze the performance of these three different indices in the patients admitted to our hospital. Methods: We performed a retrospective study in which we identified all adult patients (u003e18 years, 0.7 and 8.11% had an SI u003e 1.0. The median SI calculated for the patients with sepsis was 0.88; this was higher than the rest of admission diagnoses (p 0.7 was 5.1% and with SI u003e 1.0 was 11.3% (p 1.3 had a mortality of 10.3%, and those with an ASI u003e 50 had a mortality of 10.0% (p u003c 0.001). Conclusions: The SI, MSI, and ASI are non-invasive calculations that may provide useful information when triaging patients early during admission. The diagnosis of sepsis results in a higher median SI, which may represent better prediction in outcomes compared with the rest of admission diagnoses. In our study, the three indexes performed equally. Since the SI with a cut-off of 1.0 identified patients with higher mortality risk, we would recommend using this cut-off instead of 0.7.