Shock index and modified shock index as triage screening tools for sepsis.
J Infect Public Health
; 12(6): 822-826, 2019.
Article
en En
| MEDLINE
| ID: mdl-31113741
ABSTRACT
BACKGROUND:
Fever is one of the common conditions encountered in the emergency department, which related to a spectrum of diseases severity. Identifying sepsis patients from uncomplicated febrile patients is challenging in the emergency triage areas and pre-hospital settings.OBJECTIVES:
Assess the triage shock index (SI) and modified shock index (MSI) in febrile patients as predictors for sepsis and sepsis-related outcomes.DESIGN:
A retrospective cohort study.SETTING:
Patients presented to the Emergency Department of King Khalid University Hospital. PATIENTS ANDMETHODS:
The analysis included all febrile adult patients triaged with a temperature of 38 °C or more from January 2016 to December 2017. Based on triage vital sign we calculate the SI with cut-off levels of ≥0.7 and ≥1 and MSI with cut-off levels of ≥1 and ≥1.3. We report the Relative Risk, Sensitivity, Specificity, Positive and Negative Predictive Values of the predictors. MAIN OUTCOMEMEASURES:
Sepsis and sepsis-related outcomes such as hyperlactatemia, ICU admission, and 28 days mortality. SAMPLE SIZE 274 patients.RESULTS:
274 patients met our inclusion/exclusion criteria. Of the 274 patients, 252 patient (92%) were septic, 62 patients (22%) had hyperlactatemia, 20 patients admitted to the ICU, and 5 patient died within 28 days. An MSI of ≥1 had a sensitivity of 90% for sepsis predication, 85% for ICU admission and 100% for 28 days mortality. MSI of ≥1.3 showed a specificity (59%-100%) for all the outcomes of interest. Non-significant statistical trends of greater accuracy of MSI over SI.CONCLUSION:
MSI and SI were found to be promising predictors in triaging febrile patients. However no single cut-off values of MSI or SI were found to have an optimal accuracy for prediction of sepsis and sepsis-related outcomes. Further studies are required to assess the incorporation of MSI in a multi-item scaling system for the prediction of sepsis and its related outcomes.LIMITATIONS:
Small single center study and the results may not be generalizable.Palabras clave
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Tamizaje Masivo
/
Triaje
/
Sepsis
/
Pruebas Diagnósticas de Rutina
/
Fiebre
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Evaluation_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Infect Public Health
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
SAUDE PUBLICA
Año:
2019
Tipo del documento:
Article