Abstract
Background
The shock index is a rapid and simple tool used to predict mortality in patients with
acute illnesses including sepsis, multiple trauma, and postpartum hemorrhage. However,
its ability to predict mortality in geriatric patients with influenza in the emergency
department (ED) remains unclear. This study was conducted to clarify this issue.
Methods
We conducted a retrospective case-control study, recruiting geriatric patients (≥
65 years) with influenza visiting the ED of a medical center between January 01, 2010
and December 31, 2015. Demographic data, vital signs, shock index, past histories,
subtypes of influenza, and outcomes were included for the analysis. We investigated
the association between shock index ≥1 and 30-day mortality.
Results
In total, 409 geriatric ED patients with mean age of 79.5 years and nearly equal sex
ratio were recruited. The mean shock index ± standard deviation was 0.7 ± 0.22 and
shock index ≥1 was accounted for in 7.1% of the total patients. Logistic regression
showed that shock index ≥1 predicted mortality (odds ratio: 6.80; 95% confidence interval:
2.39–19.39). The area under the receiver operating characteristic was 0.62 and the
result of the Hosmer–Lemeshow goodness-of-fit test was 0.23. The sensitivity, specificity,
positive predictive value, and negative predictive value of a shock index ≥1 were
30.0%, 94.1%, 20.0%, and 96.4%.
Conclusions
A shock index ≥1 has a high specificity, negative predictive value, and good reliability
to predict 30-day mortality in geriatric ED patients with influenza.
Keywords
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Article Info
Publication History
Published online: May 29, 2018
Accepted:
May 28,
2018
Received in revised form:
May 20,
2018
Received:
April 7,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.