Clinical benefits of shock index and modified shock index in pulmonary embolism for 30-day mortality prognosis

Abstract

Aim: It was evaluating the shock index and the modified shock index, which are strongly correlated with the severity of the shock.Determining the risk analysis in terms of early mortality of patients diagnosed with pulmonary thromboembolism (PE) in order tospecify treatment options and prognosis. Therefore, it is important to determine the severity of pulmonary embolism correctly.The available algorithms, such as the pulmonary embolism severity index, provide a prediction of the patients according to clinicalfindings. These algorithms score abnormal vital signs, medical findings, age, and comorbid diseases. However, vital signs innormal physiological limits cause errors in determining the severity of the disease. In this case, the problem is a lack of correlationbetween the severity of the disease and vital signs. Consequently, we need a more reliable parameter. In our study, we searched fora parameter that can be calculated easily in a dynamic manner, and which is not affected by normalized vital signs. We attemptedto find a parameter that could indicate the severity of the disease. Therefore, we evaluated the shock index and the modified shockindex, which are strongly correlated with the severity of the shock.Material and Methods: Patients diagnosed with pulmonary embolism were screened retrospectively between January 2012 andDecember 2017. A total of 99 patients whose pulmonary embolism was confirmed by angio-thoracic tomography were included inthe study. Heart rate, systolic and diastolic blood pressure were measured in these patients. Mean arterial pressure, shock index andthe modified shock index were also calculated. The values showing the severity of the disease were evaluated.Result When all the parameters were examined, the predictive power of deaths within 30 days was significant at differing degrees(p