Shock index and modified shock index as a predictor of mortality in shock sepsis admitted to the critical care unit

Abstract

Introduction: Septic shock is characterized by microvascular endothelial dysfunction, dysregulated immune response, and coagulation disorders. Mortality in this state can reach up to 50%. The shock index (SI) is the integration of two physiological variables (heart rate/systolic blood pressure) and modified shock index (MSI) (heart rate/mean arterial pressure); several studies demonstrate it as a predictor of mortality in septic shock. The objective was to determine the prognostic value of the shock index and the modified shock index in patients with septic shock. Material and methods: This was an observational, prospective, and longitudinal study with 176 patients admitted to the critical care unit of Hospital Obrero No. 2, Cochabamba, Bolivia. Results: The study documented that having a SI > 1,1 and an MSI cut-off point of > 1,7 at admission to the critical care unit, presents higher mortality, with a sensitivity CI of 86% (CI: 95%: 0.714-0,869; p = 0,0001), for the MSI a sensitivity of 87% (CI: 95%: 0,722-0.874; p = 0,0001). Discussion: The shock index and modified shock index are moderately accurate predictors of mortality in patients with septic shock admitted to the critical care unit, which could be useful as a reference tool to identify high-risk patients.