Association between Shock Index and Emergency Department Cardiac Arrest
Background. In the emergency department (ED), early identification of patients at risk of cardiac arrest is paramount, especially in the context of overcrowding. The shock index (SI) is defined as the ratio of heart rate to systolic blood pressure. It is a tool used for predicting the prognosis of c...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2021/9138449 |
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| author | Chao-Tung Chen Pei-Ming Wang Chao-Hsin Wu Chih-Wei Wei Tai-Lin Huang |
| author_facet | Chao-Tung Chen Pei-Ming Wang Chao-Hsin Wu Chih-Wei Wei Tai-Lin Huang |
| author_sort | Chao-Tung Chen |
| collection | DOAJ |
| description | Background. In the emergency department (ED), early identification of patients at risk of cardiac arrest is paramount, especially in the context of overcrowding. The shock index (SI) is defined as the ratio of heart rate to systolic blood pressure. It is a tool used for predicting the prognosis of critically ill and injured patients. In this study, we have discussed the relationship between SI and cardiac arrest in the ED. Methods. Patients who experienced cardiac arrest in the ED were classified into two groups, SI ≥ 0.9 and < 0.9, according to their triage vital signs. The association between SI ≥ 0.9 and in-hospital mortality was analyzed in five different etiologies of cardiac arrest, including hypoxia, cardiac cause, bleeding, sepsis, and other metabolic problems. Results. In total, 3,313 patients experienced cardiac arrest in the ED. Among them, 1,909 (57.6%) had a SI of ≥0.9. The incidence of SI ≥ 0.9 in the five etiologies was 43.5% (hypoxia), 58.1% (cardiac cause), 56.1% (bleeding), 58.0% (sepsis), and 65.5% (other metabolic problems). SI was associated with in-hospital mortality (adjusted odds ratio (aOR), 1.6; 95% confidence interval (CI), 1.5–1.8). The aOR (CI) in the five etiologies was 1.3 (1.1–1.6) for hypoxia, 1.8 (1.6–2.1) for cardiac cause, 1.3 (0.98–1.7) for bleeding, 1.3 (1.03–1.6) for sepsis, and 1.9 (1.5–2.1) for other metabolic problems. Conclusion. More than half of the patients who experienced cardiac arrest in the ED had a SI ≥ 0.9. The SI was also associated with in-hospital mortality after cardiac arrest in the ED. SI maybe used as a screening tool to identify patients at risk of cardiac arrest in the ED and a predictor of mortality in those experiencing cardiac arrest in the ED. |
| format | Article |
| id | doaj-art-5eb34d2e298044c3823eda70243904f8 |
| institution | Kabale University |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-5eb34d2e298044c3823eda70243904f82025-02-03T07:23:28ZengWileyEmergency Medicine International2090-28402090-28592021-01-01202110.1155/2021/91384499138449Association between Shock Index and Emergency Department Cardiac ArrestChao-Tung Chen0Pei-Ming Wang1Chao-Hsin Wu2Chih-Wei Wei3Tai-Lin Huang4Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanDepartment of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, TaiwanEmergency Center of Tungs’ Taichung MetroHarbor Hospital, Taichung, TaiwanEmergency Center of Tungs’ Taichung MetroHarbor Hospital, Taichung, TaiwanEmergency Center of Tungs’ Taichung MetroHarbor Hospital, Taichung, TaiwanBackground. In the emergency department (ED), early identification of patients at risk of cardiac arrest is paramount, especially in the context of overcrowding. The shock index (SI) is defined as the ratio of heart rate to systolic blood pressure. It is a tool used for predicting the prognosis of critically ill and injured patients. In this study, we have discussed the relationship between SI and cardiac arrest in the ED. Methods. Patients who experienced cardiac arrest in the ED were classified into two groups, SI ≥ 0.9 and < 0.9, according to their triage vital signs. The association between SI ≥ 0.9 and in-hospital mortality was analyzed in five different etiologies of cardiac arrest, including hypoxia, cardiac cause, bleeding, sepsis, and other metabolic problems. Results. In total, 3,313 patients experienced cardiac arrest in the ED. Among them, 1,909 (57.6%) had a SI of ≥0.9. The incidence of SI ≥ 0.9 in the five etiologies was 43.5% (hypoxia), 58.1% (cardiac cause), 56.1% (bleeding), 58.0% (sepsis), and 65.5% (other metabolic problems). SI was associated with in-hospital mortality (adjusted odds ratio (aOR), 1.6; 95% confidence interval (CI), 1.5–1.8). The aOR (CI) in the five etiologies was 1.3 (1.1–1.6) for hypoxia, 1.8 (1.6–2.1) for cardiac cause, 1.3 (0.98–1.7) for bleeding, 1.3 (1.03–1.6) for sepsis, and 1.9 (1.5–2.1) for other metabolic problems. Conclusion. More than half of the patients who experienced cardiac arrest in the ED had a SI ≥ 0.9. The SI was also associated with in-hospital mortality after cardiac arrest in the ED. SI maybe used as a screening tool to identify patients at risk of cardiac arrest in the ED and a predictor of mortality in those experiencing cardiac arrest in the ED.http://dx.doi.org/10.1155/2021/9138449 |
| spellingShingle | Chao-Tung Chen Pei-Ming Wang Chao-Hsin Wu Chih-Wei Wei Tai-Lin Huang Association between Shock Index and Emergency Department Cardiac Arrest Emergency Medicine International |
| title | Association between Shock Index and Emergency Department Cardiac Arrest |
| title_full | Association between Shock Index and Emergency Department Cardiac Arrest |
| title_fullStr | Association between Shock Index and Emergency Department Cardiac Arrest |
| title_full_unstemmed | Association between Shock Index and Emergency Department Cardiac Arrest |
| title_short | Association between Shock Index and Emergency Department Cardiac Arrest |
| title_sort | association between shock index and emergency department cardiac arrest |
| url | http://dx.doi.org/10.1155/2021/9138449 |
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