Shock index as a predictor of mortality and adverse outcomes in patients admitted to the emergency department

Introduction: The shock index is the ratio between heart rate and systolic blood pressure, it is a useful tool for the early detection of shock in critically ill patients. These values are associated with adverse outcomes. However, the predictive ability in the Triaje scenario is not known. Objectives: To determine the predictive capacity of the shock index at the time of admission of patients to the emergency room in Triaje, for adverse clinical outcomes (hospital admission, prolonged stay and death). Methods: Based on a retrospective cohort study, the predictive capacity of the shock index for the development of adverse events was evaluated: hospital admission, prolonged stay, and mortality, by calculating Area Under the Receiver Operating Characteristic curve (AUROC). Results: A total of 6438 patients were included for the analysis, with a total of 600 adverse events during the follow-up period. 56.5% were women, the average age was 39 years. 1078 (16.7%) patients were hospitalized, of which 396 (6.1%) had a prolonged hospital stay (greater than 5 days) and 78 (1.2%) died. The discrimination capacity of the shock index for: hospital admission, prolonged stay and mortality in the multivariate analysis were: AUROC 0,84, 0,90 and 0,94, respectively. Conclusions: The shock index at emergency department admission helps distinguish relevant clinical outcomes, supporting its use as a complementary tool for risk stratification in initial triage.