ArticleCureus2025
Shock Indices as Predictors of Outcomes in Emergency Department Patients With Emergency Severity Index Level 3.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Admission shock indices and lactate for mortality risk stratification in non-traumatic hypotensive patients.Irish journal of medical science · 2026Article
- Shock index, modified shock index, and age-adjusted shock index for the prediction of impaired myocardial work in patients with ST-segment elevation myocardial infarction.Quantitative imaging in medicine and surgery · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe shock index (SI) and its derivatives, the modified shock index (MSI) and age shock index (ASI), have shown potential as prognostic tools in various clinical settings. However, their utility in predicting outcomes among Emergency Severity Index (ESI) level 3 emergency department (ED) patients remains understudied.
objectiveThis study aims to evaluate the performance of SI, MSI, and ASI in predicting length of hospital stay (LOS), in-hospital mortality, intensive care unit (ICU) admission, and readmission rates in ESI level 3 ED patients. MATERIALS AND
methodsThis prospective cross-sectional study enrolled 250 ESI level 3 patients from the ED, aged ≥20 years, at a tertiary care hospital in Pakistan, from August 1, 2021, to January 10, 2022. SI, MSI, and ASI were calculated from triage vital signs. Logistic regression analyses assessed associations between the indices and study outcomes. Predictive performance was evaluated using receiver operating characteristic (ROC) curves.
resultsAll three indices exhibited significant independent associations with mortality, even after adjusting for confounders (SI ≥1.2, OR: 11.1; MSI ≥1.0, OR: 8.82; ASI ≥36.8, OR: 12.14). ASI remained independently associated with LOS (ASI ≥36.8, OR: 3.23). ROC analyses demonstrated good predictive ability for mortality (AUC 0.84 for SI, 0.82 for ASI) and ICU admission (AUC 0.81 for SI, 0.79 for ASI).
conclusionsAmong ESI level 3 ED patients, SI ≥1.2 demonstrated strong predictive value for mortality, while ASI ≥36.8 showed moderate predictive value and was additionally associated with longer LOS. These indices, particularly the SI and ASI, may be useful adjuncts to clinical assessment for predicting mortality risk in this patient population.
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