The Usefulness of Shock Index and Modified Shock Index in Predicting the Outcome of COVID-19 Patients

Disaster Med Public Health Prep. 2021 Jun 8;1-6. doi: 10.1017/dmp.2021.187. Online ahead of print.


Objective: The aim of this study is to investigate the accuracy of shock index (SI) and modified shock index (mSI) in predicting the intensive care unit (ICU) requirement and in-hospital mortality among coronavirus disease (COVID-19) patients who are admitted to the emergency department (ED). Likewise, the effects of patients' conditions such as age, gender, and comorbidity on prognosis will be analyzed.

Methods: The files were retrospectively scanned for all COVID-19 patients over the age of 18 years who were admitted to the ED and hospitalized between January 1, 2021, and March 15, 2021. The area under the receiver operating characteristic curve and the area under the curve (AUC) were used to assess each scoring system discriminatory for predicting in-hospital mortality and ICU admission.

Results: There were 464 patients included in this study. The mean age of the patients was 62.4 ± 16.7, of which 245 were men and 219 were women. The most common comorbidity in patients was hypertension (200; 43.1%), followed by chronic obstructive pulmonary disease (174; 37.5%), and coronary artery disease (154; 33.2%). In terms of in-hospital mortality, the AUC of SI, and mSI were 0.719 and 0.739, respectively. In terms of an ICU requirement, the AUC of SI, and mSI were 0.704 and 0.729, respectively.

Conclusion: In this study, it was concluded that SI and mSI are useful in predicting in-hospital mortality and ICU requirement in COVID-19 patients. In addition, another important result of the study is that advanced age, male gender, and hypertension may be associated with a poor prognosis.

Keywords: COVID-19; intensive care units; modified shock index; mortality; shock index.