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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Autores principales:	Chao-Tung Chen, Pei-Ming Wang, Chao-Hsin Wu, Chih-Wei Wei, Tai-Lin Huang
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/5eb34d2e298044c3823eda70243904f8
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spelling	oai:doaj.org-article:5eb34d2e298044c3823eda70243904f82021-11-08T02:36:30ZAssociation between Shock Index and Emergency Department Cardiac Arrest2090-285910.1155/2021/9138449https://doaj.org/article/5eb34d2e298044c3823eda70243904f82021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/9138449https://doaj.org/toc/2090-2859Background. 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.Chao-Tung ChenPei-Ming WangChao-Hsin WuChih-Wei WeiTai-Lin HuangHindawi LimitedarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENEmergency Medicine International, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Chao-Tung Chen Pei-Ming Wang Chao-Hsin Wu Chih-Wei Wei Tai-Lin Huang Association between Shock Index and Emergency Department Cardiac Arrest
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
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
title	Association between Shock Index and Emergency Department Cardiac Arrest
title_short	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_sort	association between shock index and emergency department cardiac arrest
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/5eb34d2e298044c3823eda70243904f8
work_keys_str_mv	AT chaotungchen associationbetweenshockindexandemergencydepartmentcardiacarrest AT peimingwang associationbetweenshockindexandemergencydepartmentcardiacarrest AT chaohsinwu associationbetweenshockindexandemergencydepartmentcardiacarrest AT chihweiwei associationbetweenshockindexandemergencydepartmentcardiacarrest AT tailinhuang associationbetweenshockindexandemergencydepartmentcardiacarrest
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Association between Shock Index and Emergency Department Cardiac Arrest

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