Are shock index and adjusted shock index useful in predicting mortality and length of stay in community-acquired pneumonia?

Prasanna Sankaran, Ajay V Kamath, Syed M Tariq, Hannah Ruffell, Alexandra C Smith, Philippa Prentice, Deepak N Subramanian, Patrick Musonda, Phyo K Myint

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

BACKGROUND: Community Acquired Pneumonia (CAP) is a common infection which is associated with a significant mortality. Shock index, heart rate divided by blood pressure, has been shown to predict mortality in several conditions including sepsis, acute myocardial infarction and traumatic injuries. Very little is known about the prognostic value of shock index in community acquired pneumonia (CAP).

OBJECTIVE: To examine the usefulness of shock index (SI) and adjusted shock index (corrected to temperature) (ASI) in predicting mortality and hospital length of stay in patients admitted to hospital with CAP.

METHODS: A prospective study was conducted in three hospitals in Norfolk & Suffolk, UK. We compared risk of mortality and longer length of stay for low (=<1.0, i.e. heart rate =< systolic BP) and high (>1.0, i.e. heart rate > systolic BP) SI and ASI adjusting for age, sex and other parameters which have been shown to be associated with mortality in CAP.

RESULTS: A total of 190 patients were included (males=53%). The age range was 18-101 years (median=76 years). Patients with SI & ASI >1.0 had higher likelihood of dying within 6 weeks from admission. The adjusted odds ratio for 30 days mortality were 2.48 (1.04-5.92; p=0.04) for SI and 3.16 (1.12-8.95; p=0.03) for ASI. There was no evidence to suggest that they predict longer length of stay.

CONCLUSION: Both SI and ASI of >1.0 predict 6 weeks mortality but not longer length of stay in CAP.

Original languageEnglish
Pages (from-to)282-285
Number of pages4
JournalEuropean Journal of Internal Medicine
Volume22
Issue number3
DOIs
Publication statusPublished - Jun 2011

Fingerprint

Shock
Length of Stay
Pneumonia
Mortality
Heart Rate
Sepsis
Odds Ratio
Myocardial Infarction
Prospective Studies
Blood Pressure
Temperature
Wounds and Injuries
Infection

Keywords

  • adolescent
  • adult
  • aged
  • aged, 80 and over
  • community-acquired infections
  • female
  • Great Britain
  • hospital mortality
  • humans
  • length of stay
  • male
  • middle aged
  • pneumonia
  • predictive value of tests
  • severity of illness index
  • shock
  • young adult

Cite this

Are shock index and adjusted shock index useful in predicting mortality and length of stay in community-acquired pneumonia? / Sankaran, Prasanna; Kamath, Ajay V; Tariq, Syed M; Ruffell, Hannah; Smith, Alexandra C; Prentice, Philippa; Subramanian, Deepak N; Musonda, Patrick; Myint, Phyo K.

In: European Journal of Internal Medicine, Vol. 22, No. 3, 06.2011, p. 282-285.

Research output: Contribution to journalArticle

Sankaran, Prasanna ; Kamath, Ajay V ; Tariq, Syed M ; Ruffell, Hannah ; Smith, Alexandra C ; Prentice, Philippa ; Subramanian, Deepak N ; Musonda, Patrick ; Myint, Phyo K. / Are shock index and adjusted shock index useful in predicting mortality and length of stay in community-acquired pneumonia?. In: European Journal of Internal Medicine. 2011 ; Vol. 22, No. 3. pp. 282-285.
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title = "Are shock index and adjusted shock index useful in predicting mortality and length of stay in community-acquired pneumonia?",
abstract = "BACKGROUND: Community Acquired Pneumonia (CAP) is a common infection which is associated with a significant mortality. Shock index, heart rate divided by blood pressure, has been shown to predict mortality in several conditions including sepsis, acute myocardial infarction and traumatic injuries. Very little is known about the prognostic value of shock index in community acquired pneumonia (CAP).OBJECTIVE: To examine the usefulness of shock index (SI) and adjusted shock index (corrected to temperature) (ASI) in predicting mortality and hospital length of stay in patients admitted to hospital with CAP.METHODS: A prospective study was conducted in three hospitals in Norfolk & Suffolk, UK. We compared risk of mortality and longer length of stay for low (=<1.0, i.e. heart rate =< systolic BP) and high (>1.0, i.e. heart rate > systolic BP) SI and ASI adjusting for age, sex and other parameters which have been shown to be associated with mortality in CAP.RESULTS: A total of 190 patients were included (males=53{\%}). The age range was 18-101 years (median=76 years). Patients with SI & ASI >1.0 had higher likelihood of dying within 6 weeks from admission. The adjusted odds ratio for 30 days mortality were 2.48 (1.04-5.92; p=0.04) for SI and 3.16 (1.12-8.95; p=0.03) for ASI. There was no evidence to suggest that they predict longer length of stay.CONCLUSION: Both SI and ASI of >1.0 predict 6 weeks mortality but not longer length of stay in CAP.",
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note = "Copyright {\circledC} 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.",
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TY - JOUR

T1 - Are shock index and adjusted shock index useful in predicting mortality and length of stay in community-acquired pneumonia?

AU - Sankaran, Prasanna

AU - Kamath, Ajay V

AU - Tariq, Syed M

AU - Ruffell, Hannah

AU - Smith, Alexandra C

AU - Prentice, Philippa

AU - Subramanian, Deepak N

AU - Musonda, Patrick

AU - Myint, Phyo K

N1 - Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

PY - 2011/6

Y1 - 2011/6

N2 - BACKGROUND: Community Acquired Pneumonia (CAP) is a common infection which is associated with a significant mortality. Shock index, heart rate divided by blood pressure, has been shown to predict mortality in several conditions including sepsis, acute myocardial infarction and traumatic injuries. Very little is known about the prognostic value of shock index in community acquired pneumonia (CAP).OBJECTIVE: To examine the usefulness of shock index (SI) and adjusted shock index (corrected to temperature) (ASI) in predicting mortality and hospital length of stay in patients admitted to hospital with CAP.METHODS: A prospective study was conducted in three hospitals in Norfolk & Suffolk, UK. We compared risk of mortality and longer length of stay for low (=<1.0, i.e. heart rate =< systolic BP) and high (>1.0, i.e. heart rate > systolic BP) SI and ASI adjusting for age, sex and other parameters which have been shown to be associated with mortality in CAP.RESULTS: A total of 190 patients were included (males=53%). The age range was 18-101 years (median=76 years). Patients with SI & ASI >1.0 had higher likelihood of dying within 6 weeks from admission. The adjusted odds ratio for 30 days mortality were 2.48 (1.04-5.92; p=0.04) for SI and 3.16 (1.12-8.95; p=0.03) for ASI. There was no evidence to suggest that they predict longer length of stay.CONCLUSION: Both SI and ASI of >1.0 predict 6 weeks mortality but not longer length of stay in CAP.

AB - BACKGROUND: Community Acquired Pneumonia (CAP) is a common infection which is associated with a significant mortality. Shock index, heart rate divided by blood pressure, has been shown to predict mortality in several conditions including sepsis, acute myocardial infarction and traumatic injuries. Very little is known about the prognostic value of shock index in community acquired pneumonia (CAP).OBJECTIVE: To examine the usefulness of shock index (SI) and adjusted shock index (corrected to temperature) (ASI) in predicting mortality and hospital length of stay in patients admitted to hospital with CAP.METHODS: A prospective study was conducted in three hospitals in Norfolk & Suffolk, UK. We compared risk of mortality and longer length of stay for low (=<1.0, i.e. heart rate =< systolic BP) and high (>1.0, i.e. heart rate > systolic BP) SI and ASI adjusting for age, sex and other parameters which have been shown to be associated with mortality in CAP.RESULTS: A total of 190 patients were included (males=53%). The age range was 18-101 years (median=76 years). Patients with SI & ASI >1.0 had higher likelihood of dying within 6 weeks from admission. The adjusted odds ratio for 30 days mortality were 2.48 (1.04-5.92; p=0.04) for SI and 3.16 (1.12-8.95; p=0.03) for ASI. There was no evidence to suggest that they predict longer length of stay.CONCLUSION: Both SI and ASI of >1.0 predict 6 weeks mortality but not longer length of stay in CAP.

KW - adolescent

KW - adult

KW - aged

KW - aged, 80 and over

KW - community-acquired infections

KW - female

KW - Great Britain

KW - hospital mortality

KW - humans

KW - length of stay

KW - male

KW - middle aged

KW - pneumonia

KW - predictive value of tests

KW - severity of illness index

KW - shock

KW - young adult

U2 - 10.1016/j.ejim.2010.12.009

DO - 10.1016/j.ejim.2010.12.009

M3 - Article

C2 - 21570648

VL - 22

SP - 282

EP - 285

JO - European Journal of Internal Medicine

JF - European Journal of Internal Medicine

SN - 0953-6205

IS - 3

ER -