Use of age shock index in determining severity of illness in patients presenting to the emergency department with gastrointestinal bleeding

Kocaoğlu, Salih; Çetinkaya, Hasan Basri

doi:10.1016/j.ajem.2021.05.008

Cited by 7 publications

(8 citation statements)

References 16 publications

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“…ASI, easily calculated during triage, proved more effective in predicting critical patients with gastrointestinal bleeding, emphasizing its clinical significance in risk assessment for this condition [6]. Yu et al [19] showed that ASI could predict long-term prognosis in patients with ACS in a study with 2060 patients.…”

Section: Discussionmentioning

confidence: 99%

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Age shock index as an early predictor of cardiovascular death in acute coronary syndrome patients

Carvalho,

Bernardo,

Carvalho

et al. 2024

Coronary Artery Disease

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Background The shock index (SI), reflecting heart rate (HR) to SBP ratio, is established for predicting adverse outcomes in acute coronary syndrome (ACS) patients. Exploring the age shock index (ASI), obtained by multiplying SI with age, could offer further insights into ACS prognosis. Objectives Assess ASI’s effectiveness in predicting in-hospital death in individuals with ACS. Methods This study encompassed patients with acute myocardial infarction, drawn from a national registry spanning October 2010 to January 2022. The optimal ASI threshold was established using receiver operating characteristic (ROC) curve analysis. The primary outcome was in-hospital mortality. Results A total of 27 312 patients were enrolled, exhibiting a mean age of 66 ± 13 years, with 72.3% being male and 47.5% having ST-elevation myocardial infarction. ROC analysis yielded an area under the curve (AUC) of 0.80, identifying the optimal ASI cutoff as 44. Multivariate regression analysis, adjusting for potential confounders, established ASI ≥ 44 as an independent predictor of in-hospital death [hazard ratio: 3.09, 95% confidence interval: 2.56–3.71, P < 0.001]. Furthermore, ASI emerged as a notably superior predictor of in-hospital death compared to the SI (AUCASI = 0.80 vs. AUCSI = 0.72, P < 0.0001), though it did not outperform the Global Registry of Acute Coronary Events (GRACE) score (AUCASI = 0.80 vs. AUCGRACE = 0.85, P < 0.001) or thrombolysis in myocardial infarction (TIMI) risk index (AUCASI = 0.80 vs. AUCTIMI = 0.84, P < 0.001). Conclusion The ASI offers an expedient mean to promptly identify ACS patients at elevated risk of in-hospital death. Its simplicity and effectiveness could render it a valuable tool for early risk stratification in this population.

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Section: Discussionmentioning

confidence: 99%

“…The age shock index (ASI), calculated by multiplying SI with the patient’s age, has been used for mortality prediction in Emergency Severity Index level 3 [5] and to determine the severity of illness in patients presenting to the emergency department with gastrointestinal bleeding [6].…”

Section: Introductionmentioning

confidence: 99%

Age shock index as an early predictor of cardiovascular death in acute coronary syndrome patients

Carvalho,

Bernardo,

Carvalho

et al. 2024

Coronary Artery Disease

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“…Bozkurt et al found that a MEWS score > 2 predicts in-hospital mortality in adult patients with AUGIB in the ED with an AUC of 0.722 [ 17 ]. Kocaoğlu et al have proven that SI and age SI can quickly distinguish critical patients with gastrointestinal bleeding in the ED [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although several physiological scoring systems have been proposed as predictors of mortality due to AUGIB in the ED, most have comprised advanced parameters such as endoscopic diagnosis and laboratory information. However, previous publications have proven that simple and obtainable-by-the-bed clinical physiological scoring systems are beneficial for risk stratification [ 17 , 18 ], but the performance of these rapid, easily calculated clinical scoring systems has not been studied in elderly populations. The aim of this study is to evaluate clinical physiological scoring systems for predicting in-hospital mortality in elderly patients with AUGIB in the ED.…”

Section: Introductionmentioning

confidence: 99%

Performance of Six Clinical Physiological Scoring Systems in Predicting In-Hospital Mortality in Elderly and Very Elderly Patients with Acute Upper Gastrointestinal Bleeding in Emergency Department

Hung

et al. 2023

Medicina

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Background and Objectives: The aim of this study is to compare the performance of six clinical physiological-based scores, including the pre-endoscopy Rockall score, shock index (SI), age shock index (age SI), Rapid Acute Physiology Score (RAPS), Rapid Emergency Medicine Score (REMS), and Modified Early Warning Score (MEWS), in predicting in-hospital mortality in elderly and very elderly patients in the emergency department (ED) with acute upper gastrointestinal bleeding (AUGIB). Materials and Methods: Patients older than 65 years who visited the ED with a clinical diagnosis of AUGIB were enrolled prospectively from July 2016 to July 2021. The six scores were calculated and compared with in-hospital mortality. Results: A total of 336 patients were recruited, of whom 40 died. There is a significant difference between the patients in the mortality group and survival group in terms of the six scoring systems. MEWS had the highest area under the curve (AUC) value (0.82). A subgroup analysis was performed for a total of 180 very elderly patients (i.e., older than 75 years), of whom 27 died. MEWS also had the best predictive performance in this subgroup (AUC, 0.82). Conclusions: This simple, rapid, and obtainable-by-the-bed parameter could assist emergency physicians in risk stratification and decision making for this vulnerable group.

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“…10 Besides, age SI has been validated for the prediction of mortality of patients presenting to the emergency department (ED). [11][12][13] The clinical mainstay of COVID-19 pneumonia is respiratory distress that exhibits cyanotic features. Xie et al 14 focused on oxygen saturation as a prognostic biomarker of the disease and profound hypoxemia was related to the mortality of COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

The new combination of oxygen saturation with age shock index predicts the outcome of COVID-19 pneumonia

Oh,

Lee

2023

SAGE Open Medicine

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Introduction: Emergency departments around the world have been struggling to deal with patients with COVID-19 and presumed COVID-19. Triaging patients who need further medical support is the key matter to emergency physicians as the delay of proper treatment may worsen the results. The aim of this study was to validate the ability of age shock index and hypoxia-age-shock index at the time of presentation to the emergency department to predict case fatality in patients with COVID-19 pneumonia. Methods: We only included patients who had COVID-19-associated pneumonia who needed in-hospital treatment. The vital signs and oxygen saturation used in the study were collected, especially from the triage sector, before patients were given supplemental oxygen. Results: A total of 241 patients enrolled in the study. The case fatality rate was 27%. The median age of the study samples was 78 (66–86) years with 133 male and 108 female patients. Hypoxia-age-shock index showed the best performance in analysis (odds ratio 15.1, 95% confidence interval: 5.1–44.4; adjusted odds ratio 8.6, 95% confidence interval: 2.8–26.8). Conclusion: The hypoxia-age-shock index was a strong predictor for in-hospital mortality of COVID-19 pneumonia. Furthermore, when it was compared with age shock index, hypoxia-age-shock index showed better performance in predicting fatality of the disease.

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Use of age shock index in determining severity of illness in patients presenting to the emergency department with gastrointestinal bleeding

Cited by 7 publications

References 16 publications

Age shock index as an early predictor of cardiovascular death in acute coronary syndrome patients

Age shock index as an early predictor of cardiovascular death in acute coronary syndrome patients

Performance of Six Clinical Physiological Scoring Systems in Predicting In-Hospital Mortality in Elderly and Very Elderly Patients with Acute Upper Gastrointestinal Bleeding in Emergency Department

The new combination of oxygen saturation with age shock index predicts the outcome of COVID-19 pneumonia

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