The predictive value of the shock index and modified shock index for the short-term mortality in patients with acute pulmonary embolism

The predictive value of the shock index and modified shock index for the short-term mortality in patients with acute pulmonary embolism

Aim: The purpose of the study was to examine the relationship of shock index (SI) and modified shock index (MSI) with pulmonaryembolism severity index (PESI) score in predicting short-term death in acute pulmonary embolism (APE) patients.Material and Methods: This retrospective analysis included 104 consecutive patients whose APE was confirmed using computerizedtomographic pulmonary angiography. For each patient, the PESI score, the SI, and the MSI were calculated. The main endpoint of thestudy was short-term mortality.Results: Patients based on hemodynamic status or the PESI score upon admission were allocated into high risk and non-high riskgroups. We noted that SI and MSI were significantly elevated in a high risk group (1.17 ± 0.17 vs. 0.77 ± 0.17 and 1.54 ± 0.29 vs. 1.05± 0.21, respectively, p < 0.001). In a correlation analysis, we showed that SI and MSI were significantly correlated with the PESI scorefor short-term mortality (r = 0.491 and r = 0.504, respectively, p < 0.001). An area under curve value of SI and MSI for short-termdeath were 0.66 (0.52-0.79 95% CI, p = 0.022) and 0.67 (0.53-0.80 95% CI, p = 0.026) respectively.Conclusion: The present study findings demonstrated that the SI and MSI may be applicable in predicting short-death in patientswith APE.

___

  • 1. Heit JA. The Epidemiology of Venous Thromboembolism in the Community. Arterioscler Thromb Vasc Biol 2008;28:370-2.
  • 2. Konstantinides SV, Torbicki A, Agnelli G, et al. Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). 2014 ESC guidelines on the diagnosis and Management of acute pulmonary embolism. Eur Heart J 2014;35:3033-69.
  • 3. Pollack CV, Schreiber D, Goldhaber SZ, et al. Clinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter Emergency Medicine Pulmonary Embolism in the Real World Registry). J Am Coll Cardiol 2011;57:700-6.
  • 4. Laporte S, Mismetti P, Décousus H, et al. RIETE Investigators. Clinical predictors for fatal pulmonary embolism in 15,520 patients with venous thromboembolism: findings from the Registro Informatizado de la Enfermedad TromboEmbolica venosa (RIETE) Registry. Circulation 2008;117:1711- 6.
  • 5. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999;353:1386-9.
  • 6. Bozbay M, Uyarel H, Avsar S, et al. Creatinine kinase isoenzyme-MB: A simple prognostic biomarker in patients with pulmonary embolism treated with thrombolytic therapy. J Crit Care 2015;30:1179-83.
  • 7. Aujesky D, Obrosky DS, et al. Derivation and Validation of a Prognostic Model for Pulmonary Embolism. Am J Respir Crit Care Med 2005;172:1041-6.
  • 8. Zhou XY, Ben SQ, Chen HL, et al. The prognostic value of pulmonary embolism severity index in acute pulmonary embolism: a meta-analysis. Respir Res 2012;13:111.
  • 9. Cannon CM, Braxton CC, Kling-Smith M, et al. Utility of the Shock Index in Predicting Mortality in Traumatically Injured Patients. J Trauma 2009;67:1426-30.
  • 10. Liu YC, Liu JH, Fang ZA, et al. Modified shock index and mortality rate of emergency patients. World J Emerg Med 2012;3:114-7.
  • 11. Kim SY, Hong KJ, Shin SD, et al. Validation of the Shock Index, Modified Shock Index, and Age Shock Index for Predicting Mortality of Geriatric Trauma Patients in Emergency Departments. J Korean Med Sci 2016;31:2026-32.
  • 12. Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 1989;2:358-67.
  • 13. Oh JK, Hagler DJ, Cabalka A, et al. Transesophageal and intracardiac echocardiography. In: Oh JK, Seward JB, Tajik AJ, eds. The Echo Manual 3rd ed. Philadelphia, PA: Lippincott Williams&Wilkins 2006:29-58.
  • 14. Bĕlohlávek J, Dytrych V, Linhart A. Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism. Exp Clin Cardiol 2013;18:129-38.
  • 15. Pinsky MR. The right ventricle: interaction with the pulmonary circulation. Crit Care 2016;20:266.
  • 16. Jiménez D, Uresandi F, Otero R, et al. Troponin-based risk stratification of patients with acute nonmassive pulmonary embolism: systematic review and metaanalysis. Chest 2009;136:974-82.
  • 17. Klok FA, Mos IC, Huisman MV. Brain-type natriuretic peptide levels in the prediction of adverse outcome in patients with pulmonary embolism: a systematic review and meta-analysis. Am J Respir Crit Care Med 2008;178:425-30.
  • 18. Puls M, Dellas C, Lankeit M, et al. Heart-type fatty acid-binding protein permits early risk stratification of pulmonary embolism. Eur Heart J 2007;28:224-9.
  • 19. Khemasuwan D, Yingchoncharoen T, Tunsupon P, et al. Right ventricular echocardiographic parameters are associated with mortality after acute pulmonary embolism. J Am Soc Echocardiogr 2015; 28:355-62.
  • 20. Trujillo-Santos J, den Exter PL, Gómez V, et al. Computed tomography-assessed right ventricular dysfunction and risk stratification of patients with acute non-massive pulmonary embolism: systematic review and meta-analysis. J Thromb Haemost 2013; 11:1823-32.
  • 21. Righini M, Roy PM, Meyer G, et al. The Simplified Pulmonary Embolism Severity Index (PESI): validation of a clinical prognostic model for pulmonary embolism. J Thromb Haemost. 2011; 9:2115-7.
  • 22. Donzé J, Le Gal G, Fine MJ, et al. Prospective validation of the Pulmonary Embolism Severity Index. A clinical prognostic model for pulmonary embolism. Thromb Haemost 2008;100:943-8.
  • 23. Aujesky D, Obrosky DS, Stone RA, et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med 2005; 172:1041- 6.
  • 24. Terceros-Almanza LJ, García-Fuentes C, BermejoAznárez S, et al. Prediction of massive bleeding. Shock index and modified shock index. Med Intensiva 2017;41:532-8.
  • 25. Yu T, Tian C, Song J, et al. Age Shock Index is Superior to Shock Index and Modified Shock Index for Predicting Long-Term Prognosis in Acute Myocardial Infarction. Shock 2017;48:545-50.
Annals of Medical Research-Cover
  • Yayın Aralığı: 12
  • Yayıncı: İnönü Üniversitesi Tıp Fakültesi
Sayıdaki Diğer Makaleler

Structural analysis of the choroid and the optic nerve in diabetes mellitus

Zeynep Eylül ERCAN

Serum oxidative stress level correlates with epicardial adipose tissue thickness in heart failure-reduced ejection fraction patients

Gökhan CEYHUN, Mutlu BÜYÜKLÜ, Ergün KUTLUSOY

Nasofacial and canthal morphometric analysis of Benue Indigenes in central Nigeria

Terkuma CHİA

Evaluation of psychological stress and cortisol levels in males with and without gingivitis

Kübra ARAL, Michael R. MİLWARD, Paul R. COOPER, Özge ÇELİK GÜLER

Can mean platelet volume (MPV) and platelet/lymphocyte ratio (PLR) be an early predictor for severe acute pancreatitis?

Yasemin GÖKDEN, Orkide KUTLU

Our surgical experience in cholangiocellular carcinoma

Uğur TOPAL, Ahmet Gökhan SARITAŞ, Abdullah ÜLKÜ, Kubilay DALCI, Erdi AYDIN, Atılgan Tolga AKÇAM

The rare cause of fever with unknown origin in childhood: Abdominal Tuberculosis

Erdem TOPAL, Hilal KARABAĞ ÇITLAK

Circulation levels of YKL-40 and Hs-CRP in stage 3 Molar-incisor pattern of periodontitis

Zeynep Pınar KELEŞ YÜCEL, Umut BALLI

Investigation of the characteristics differentiating complicated and non-complicated appendicitis: A prospective analysis

Kasım TURGUT, Sabri ÖZDAŞ, Mehmet ŞİRİK, İrfan AYDIN

A day 1 hCG can differentiate non-viable intrauterine pregnancy and ectopic pregnancy following endometrial curettage

Dilek ŞAHİN, Aykan YÜCEL, Özgür KARA, Gülay GENÇOSMANOĞLU TÜRKMEN, Cem Yaşar SANHAL, Bergen LALELİ KOÇ, Halil Korkut DAĞLAR