Research Article
BibTex RIS Cite

Evaluation of shock index and modified shock index in estimation of MACE parameters in patients with ST elevated myocardial infarction

Year 2021, Volume: 46 Issue: 2, 410 - 417, 30.06.2021
https://doi.org/10.17826/cumj.792805

Abstract

Purpose: Shock index and modified shock index were used to evaluate the hemodynamic status of patients with trauma, pulmonary embolism and aortic dissection. In this study, we aimed to evaluate the effectiveness of shock index and modified shock index as an indicator of major adverse cardiac event parameters in patients with ST elevated myocardial infarction.
Materials and Methods: A total of 194 patients with ST elevated myocardial infarction were included in the study. Shock index and modified shock index were evaluated regarded to predicting major adverse cardiac event and major adverse cardiac event parameters separately.
Results: A total of 194 patients were included in the study. The 7-day mortality was 2.4% in the shock index <0.66 group and 11.6% in the shock index ≥ 0.66 group. The rate of development of major adverse cardiac event was 4.0% for shock index <0.66 and 17.4% for shock index 0.66. The 7-day mortality was 3.0% in the modified shock index <0.93 group and 11.1% in the modified shock index 0.93 group. The rate of major adverse cardiac event was 3.8% in the modified shock index <0.93 group and 19.4% in the modified shock index ≥ 0.93 group.
Conclusion: Shock index and modified shock index are useful methods for estimating both major adverse cardiac event and major adverse cardiac event parameters separately.

References

  • Rady MY, Smithline HA, Blake H, Nowak R, Rivers E, et al. Comparison of shock index and conventional vital signs to identify acute, critical illness in emergency department. Ann Emerg Med 1994;24:685–90.
  • Cannon CM, Braxton CC, Kling-Smith M, Mahnken JD, Carlton E, et al. Utility of the shock index in predicting mortality in traumatically injured patients. J Trauma. 2009 Dec;67(6):1426-30.
  • Toosi MS, Merlino JD, Leeper KV. Prognostic Value of the Shock Index Along With Transthoracic Echocardiography in Risk Stratification of PatientsWith Acute Pulmonary Embolism[J]. Am J Cardiol 2008;101(5):700–5.
  • Guo ZJ, Lin Q, Zi XR, Xu Q, Liu HT, et al. Correlation of computed tomography angiography parameters and shock index to assess the ransportation risk in aortic dissection patients. Radiol Med 2015;120(4):386–92.
  • Bilkova D, Motovska Z, Widimsky P, Dvorak J, Lisa L, et al. Shock index: a simple clinical parameter for quick mortality risk assessment in acute myocardial infarction.Can J Cardiol. 2011 Nov-Dec;27(6):739-42.
  • Huang B, Yang Y, Zhu J, Liang Y, Tan H, et al. Usefulness of the admission shock index for predicting short-term outcomes in patients with ST-segment elevation myocardial infarction. Am J Cardiol 2014;114:1315–21.
  • Spyridopoulos I, Noman A, Ahmed JM, Das R, Edwards R, et al. Eur Heart J Acute Cardiovasc Care. 2015 Jun;4(3):270-7.
  • Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, et al; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal (2018) 39, 119–177
  • Liu YC, Liu JH, Fang ZA, Shan GL, Xu J, et al. Modified shock index and mortality rate of emergency patients. World J Emerg Med 2012;3:114–7.
  • O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction[J]. J Am Coll Cardiol 2013;61 (4):e78-140.
  • Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)[J]. Eur Heart J 2012;33:2569–619.
  • Abreu G, Azevedo P, Braga CG, Vieira C, Pereira MA, et al. Modified shock index: A bedside clinical index for risk assessment of ST-segment elevation myocardial infarction at presentation. Rev Port Cardiol. 2018;37(6):481-8.
  • Hwang JK, Jang WJ, Song YB, Lima JA, Guallar E, et al. Shock Index as a Predictor of Myocardial Injury in ST-segment Elevation Myocardial Infarction. Am J Med Sci. 2016 Dec;352(6):574-581.
  • Shangguan Q, Xu JS, Su H, Li JX, Wang WY, et al. Modified shock index is a predictor for 7-day outcomes in patients with STEMI. Am J Emerg Med 2015; 33: 1072 – 1075.
  • Allie E Goins, Robert Rayson, Michael Yeung & George A Stouffer. The use of hemodynamics to predict mortality in patients undergoing primary PCI for ST-elevation myocardial infarction. Expert Review of Cardiovascular Therapy 2018;1:1-26.
  • Singh A, Ali S, Agarwal A, Srivastava RN. Correlation of shock index and modified shock index with the outcome of adult trauma patients: a prospective study of 9860 patients. N Am J Med Sci. 2014;6:450-2.
  • Jomaa W, Hamdi S, Ben Ali I. Risk profile and in-hospital prognosis in elderly patients presenting for acute ST-elevation myocardial infarction in the Tunisian context. Indian Heart J. 2016 Nov -Dec; 68(6):760-765. .
  • Balzi D, Barchielli A, Buiatti E, Franceschini C, Mangani I, et al. Age and comorbidity in acute myocardial infarction: a report from the AMI-Florence Italian registry. Am J Geriatr Cardiol. 2006 Jan-Feb;15(1):35-41.

ST elevasyonlu miyokard enfarktüslü hastalarda MACE parametrelerinin tahminde şok indeksi ve modifiye şok indeksinin değerlendirilmesi

Year 2021, Volume: 46 Issue: 2, 410 - 417, 30.06.2021
https://doi.org/10.17826/cumj.792805

Abstract

Amaç: Şok indeksi ve modifiye şok indeksi travma, pulmoner emboli ve aort diseksiyonu olan hastaların hemodinamik durumunu değerlendirmek için kullanılmıştır. Bu çalışmada ST elevasyonlu miyokard infarktüs hastalarında majör istenmeyen kardiyak olay parametrelerinin bir göstergesi olarak şok indeksi ve modifiye şok indeksinin etkinliğini değerlendirmeyi amaçladık.
Gereç ve Yöntem: Çalışmaya ST elevasyonlu miyokard enfarktüsü olan toplam 194 hasta dahil edildi. Şok indeksi ve modifiye şok indeksinin majör istenmeyen kardiyak olayı ve majör istenmeyen kardiyak olay parametrelerini ayrı ayrı öngörme açısından değerlendirildi.
Bulgular: Çalışmaya toplam 194 hasta dahil edildi. 7 günlük mortalite şok indeksi <0.66 grubunda %2.4 ve şok indeksi ≥ 0.66 grubunda %11.6 idi. Majör istenmeyen kardiyak olay gelişme oranı şok indeksi <0.66 için %4.0 ve şok indeksi ≥0.66 için %17.4 idi. 7 günlük mortalite modifiye şok indeksi <0.93 grubunda %3.0 ve modifiye şok indeksi ≥0.93 grubunda% 11.1 idi. Majör istenmeyen kardiyak olay gelişme oranı modifiye şok indeksi <0.93 grubunda % 3.8 ve modifiye şok indeksi ≥ 0.93 grubunda% 19.4 idi.
Sonuç: Şok indeksi ve modifiye şok indeksi, hem majör istenmeyen kardiyak olay gelişimini hem de majör istenmeyen kardiyak olay parametrelerini ayrı ayrı hesaplamak için faydalı yöntemlerdir.

References

  • Rady MY, Smithline HA, Blake H, Nowak R, Rivers E, et al. Comparison of shock index and conventional vital signs to identify acute, critical illness in emergency department. Ann Emerg Med 1994;24:685–90.
  • Cannon CM, Braxton CC, Kling-Smith M, Mahnken JD, Carlton E, et al. Utility of the shock index in predicting mortality in traumatically injured patients. J Trauma. 2009 Dec;67(6):1426-30.
  • Toosi MS, Merlino JD, Leeper KV. Prognostic Value of the Shock Index Along With Transthoracic Echocardiography in Risk Stratification of PatientsWith Acute Pulmonary Embolism[J]. Am J Cardiol 2008;101(5):700–5.
  • Guo ZJ, Lin Q, Zi XR, Xu Q, Liu HT, et al. Correlation of computed tomography angiography parameters and shock index to assess the ransportation risk in aortic dissection patients. Radiol Med 2015;120(4):386–92.
  • Bilkova D, Motovska Z, Widimsky P, Dvorak J, Lisa L, et al. Shock index: a simple clinical parameter for quick mortality risk assessment in acute myocardial infarction.Can J Cardiol. 2011 Nov-Dec;27(6):739-42.
  • Huang B, Yang Y, Zhu J, Liang Y, Tan H, et al. Usefulness of the admission shock index for predicting short-term outcomes in patients with ST-segment elevation myocardial infarction. Am J Cardiol 2014;114:1315–21.
  • Spyridopoulos I, Noman A, Ahmed JM, Das R, Edwards R, et al. Eur Heart J Acute Cardiovasc Care. 2015 Jun;4(3):270-7.
  • Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, et al; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal (2018) 39, 119–177
  • Liu YC, Liu JH, Fang ZA, Shan GL, Xu J, et al. Modified shock index and mortality rate of emergency patients. World J Emerg Med 2012;3:114–7.
  • O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction[J]. J Am Coll Cardiol 2013;61 (4):e78-140.
  • Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)[J]. Eur Heart J 2012;33:2569–619.
  • Abreu G, Azevedo P, Braga CG, Vieira C, Pereira MA, et al. Modified shock index: A bedside clinical index for risk assessment of ST-segment elevation myocardial infarction at presentation. Rev Port Cardiol. 2018;37(6):481-8.
  • Hwang JK, Jang WJ, Song YB, Lima JA, Guallar E, et al. Shock Index as a Predictor of Myocardial Injury in ST-segment Elevation Myocardial Infarction. Am J Med Sci. 2016 Dec;352(6):574-581.
  • Shangguan Q, Xu JS, Su H, Li JX, Wang WY, et al. Modified shock index is a predictor for 7-day outcomes in patients with STEMI. Am J Emerg Med 2015; 33: 1072 – 1075.
  • Allie E Goins, Robert Rayson, Michael Yeung & George A Stouffer. The use of hemodynamics to predict mortality in patients undergoing primary PCI for ST-elevation myocardial infarction. Expert Review of Cardiovascular Therapy 2018;1:1-26.
  • Singh A, Ali S, Agarwal A, Srivastava RN. Correlation of shock index and modified shock index with the outcome of adult trauma patients: a prospective study of 9860 patients. N Am J Med Sci. 2014;6:450-2.
  • Jomaa W, Hamdi S, Ben Ali I. Risk profile and in-hospital prognosis in elderly patients presenting for acute ST-elevation myocardial infarction in the Tunisian context. Indian Heart J. 2016 Nov -Dec; 68(6):760-765. .
  • Balzi D, Barchielli A, Buiatti E, Franceschini C, Mangani I, et al. Age and comorbidity in acute myocardial infarction: a report from the AMI-Florence Italian registry. Am J Geriatr Cardiol. 2006 Jan-Feb;15(1):35-41.
There are 18 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Research
Authors

Pınar Yeşim Akyol 0000-0003-2477-1443

Zeynep Karakaya 0000-0003-0562-8297

Fatih Topal 0000-0002-9941-4224

Rıfat Urnal This is me 0000-0003-1054-1794

Murat Acar This is me 0000-0002-1905-7133

Umut Payza 0000-0002-5297-1066

Serkan Bilgin This is me 0000-0001-9345-8878

Publication Date June 30, 2021
Acceptance Date January 16, 2021
Published in Issue Year 2021 Volume: 46 Issue: 2

Cite

MLA Akyol, Pınar Yeşim et al. “Evaluation of Shock Index and Modified Shock Index in Estimation of MACE Parameters in Patients With ST Elevated Myocardial Infarction”. Cukurova Medical Journal, vol. 46, no. 2, 2021, pp. 410-7, doi:10.17826/cumj.792805.