Comparison of the effectiveness of shock index, modified shock index, and age shock index in copd exacerbations

Abstract

Objective: To evaluate the effectiveness and practicality of shock index (SI), modified shock index (MSI), and age-shock index (Age-SI) in predicting the prognosis, mortality, ICU and service admission, and the need for intermittent mandatory ventilation (IMV) and nasal intermittent mandatory ventilation) (NIMV in the ED patients with chronic obstructive pulmonary disease (COPD) exacerbation. Study Design: Retrospective study. Place and Duration of Study: Balikesir University Faculty of Medicine, Emergency Service, Balıkesir, Turkey, from January 2019 to May 2020. Methodology: Adult patients, who were admitted to the Emergency Department with diagnosis of COPD exacerbation, were included. Patients with missing data were excluded. SI, MSI, and age-SI values were calculated by using the vital signs. ROC curve analysis was used to evaluate the diagnostic performances of SI, MSI, and age-SI. Results: The study consisted of 201 patients, 152 (75.6%) were males. Six (3%) patients died, 26 (12%) were admitted to ICU, 112 (55.7%) were admitted to the service, 11 (5.5%) needed IMV, and 48 (23.9%) needed NIMV in ED. SI was superior to the MSI and age-SI in predicting mortality, and AUC values of 0.802, 0.727, and 0.704, respectively. SI was also superior to the MSI and age-SI in predicting hospital admissions (SI AUC=0.591, p=0.029; MSI AUC=0.572, p=0.059; and age-SI AUC=0.580, p=0.089). Conclusion: Respectively none of the three indices was independently sufficient in predicting IMV, NIMV, and the need for ICU. SI is a valuable parameter in discriminating the COPD exacerbation. It is superior to the MSI and age-SI in predicting mortality and hospital admissions. It will be useful to evaluate SI for the severity classification, follow-up, and management of the patients with COPD.