1887
Volume 2024, Issue 7
  • ISSN: 1999-7086
  • E-ISSN: 1999-7094

ملخص

Septic shock remains a critical medical condition with significant morbidity and mortality rates worldwide. Early and accurate risk assessment is crucial for optimizing patient management and improving outcomes. Various clinical indices and biochemical markers have been proposed as predictive tools for assessing the severity of septic shock and its associated morbidity and mortality. The aim of the study was to compare the predictive validity of the MSI (modified shock index), SI (shock index), ASI (age shock index), and qSOFA (quick sequential organ failure assessment) score with metabolic acidosis, anion gap, base deficit, and lactate levels in the assessment of morbidity and mortality outcomes in adult patients diagnosed with septic shock.

A prospective observational study was conducted in a tertiary care hospital. This study included 264 patients who were diagnosed with sepsis. Ethical approval was obtained from the institutional ethical committee. A data collection sheet was used for collecting data, including both clinical and metabolic parameters. Receiver operating characteristic analysis was performed using coGuide REAP.

The median age of participants was 60 years (IQR (interquantile range): 45–70 years). The predictive validity of metabolic parameters was higher in predicting “mortality” as indicated by the area under the curve (AUC) values (lactate: 0.816, base deficit: 0.816) compared with clinical parameters (ASI: 077, SI: 0.709). The predictive validity of clinical parameters was higher in predicting “morbidity” as indicated by AUC values (ASI: 0.761, MSI: 0.698) compared with metabolic parameters (base deficit: 0.728, anion gap: 0.611).

Predictive validity was higher for clinical parameters related to morbidity and higher for metabolic parameters related to mortality.

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References

  1. Delano MJ, Ward PA. The immune system's role in sepsis progression, resolution and long-term outcome. Immunol Rev. 2016 Nov; 274(1):330–53. doi: 10.1111/imr.12499.
    [Google الباحث العلمي]
  2. Basodan N, Al Mehmadi AE, Al Mehmadi AE, Aldawood SM, Hawsawi A, Fatini F, et al. Septic shock: Management and outcomes. Cureus. 2022 Dec 3; 14(12):e32158. doi: 10.7759/cureus.32158.
    [Google الباحث العلمي]
  3. Alam N, Doerga KB, Hussain T, Hussain S, Holleman F, Kramer MH, et al. Epidemiology, recognition and documentation of sepsis in the pre-hospital setting and associated clinical outcomes: A prospective multicenter study. Acute Med J. 2016 Oct; 15(4):168–75. doi: 10.52964/AMJA.0632.
    [Google الباحث العلمي]
  4. Chamberlain DJ, Willis E, Clark R, Brideson G. Identification of the severe sepsis patient at triage: A prospective analysis of the Australasian Triage Scale. Emerg Med J. 2015 Sep; 32(9):690–7. doi: 10.1136/emermed-2014-203937.
    [Google الباحث العلمي]
  5. Sunavala JD. Preventability of death in a medical ICU in a developing country. Indian J Crit Care Med. 2014 Feb; 18(2):59–61. doi: 10.4103/0972-5229.126073.
    [Google الباحث العلمي]
  6. Smyth MA, Brace-McDonnell SJ, Perkins GD. Identification of adults with sepsis in the prehospital environment: A systematic review. BMJ Open. 2016 Aug; 6(8):e011218. doi: 10.1136/bmjopen-2016-011218.
    [Google الباحث العلمي]
  7. Rivers EP, McIntyre L, Morro DC, Rivers KK. Early and innovative interventions for severe sepsis and septic shock: Taking advantage of a window of opportunity. Can Med Assoc J. 2005 Oct; 173(9):1054–65. doi: 10.1503/cmaj.050632.
    [Google الباحث العلمي]
  8. Middleton DJ, Smith TO, Bedford R, Neilly M, Myint PK. Shock index predicts outcome in patients with suspected sepsis or community-acquired pneumonia: A systematic review. J Clin Med. 2019 Jul 31; 8(8):1144. doi: 10.3390/jcm8081144.
    [Google الباحث العلمي]
  9. Zhang T-N, Hao P-H, Gao S-Y, Liu C-F, Yang N. Evaluation of SI, MSI and DSI for very early (3-day) mortality in patients with septic shock. Eur J Med Res. 2022 Nov 3; 27(1):227. doi: 10.1186/s40001-022-00857-y.
    [Google الباحث العلمي]
  10. Marik PE, Taeb AM. SIRS, qSOFA and new sepsis definition. J Thorac Dis. 2017 Apr; 9(4):943–5. doi: 10.21037/jtd.2017.03.125.
    [Google الباحث العلمي]
  11. Jung B, Martinez M, Claessens Y-E, Darmon M, Klouche K, Lautrette A, et al. Diagnosis and management of metabolic acidosis: Guidelines from a French expert panel. Ann Intensive Care 2019 Aug; 9(1):92. doi: 10.1186/s13613-019-0563-2.
    [Google الباحث العلمي]
  12. Asati AK, Gupta R, Behera D. To Determine blood lactate levels in patients with sepsis admitted to a respiratory intensive care unit and to correlate with their hospital outcomes. Int J Crit Care Emerg Med. 2018 Sep, 4(2):045. doi: 10.23937/2474-3674/1510045.
    [Google الباحث العلمي]
  13. Shahsavarinia K, Moharramzadeh P, Arvanagi RJ, Mahmoodpoor A. qSOFA score for prediction of sepsis outcome in emergency department. Pak J Med Sci. 2020 May -Jun; 36(4):668–72. doi: 10.12669/pjms.36.4.2031.
    [Google الباحث العلمي]
  14. Burnham JP, Kollef MH. qSOFA score: Predictive validity in Enterobacteriaceae bloodstream infections. J Crit Care. 2018 Feb;43:143–7. doi: 10.1016/j.jcrc.2017.09.011.
    [Google الباحث العلمي]
  15. BDSS Corp. Released 2020. Reap coGuide statistics software, Version 1.0.3, India: BDSS Corp. Available from: Https://Reap.Coguide.in [Accessed 14th Jul 2023].
    [Google الباحث العلمي]
  16. Liu Y-C, Liu J-H, Fang ZA, Shan G-L, Xu J, Qi Z-W, et al.. Modified shock index and mortality rate of emergency patients. World J Emerg Med. 2012; 3(2):114–7. doi: 10.5847/wjem.j.issn.1920-8642.2012.02.006.
    [Google الباحث العلمي]
  17. Torabi M, Moeinaddini S, Mirafzal A, Rastegari A, Sadeghkhani N. Shock index, modified shock index, and age shock index for prediction of mortality in emergency severity index level 3. Am J Emerg Med. 2016 Nov; 34(11):2079–83. doi: 10.1016/j.ajem.2016.07.017.
    [Google الباحث العلمي]
  18. Rassameehiran S, Teerakanok J, Suchartlikitwong S, Nugent K. Utility of the shock index for risk stratification in patients with acute upper gastrointestinal bleeding. South Med J. 2017 Nov; 110(11):738–43. doi: 10.14423/SMJ.0000000000000729.
    [Google الباحث العلمي]
  19. Allgöwer M, Burri C. “Schockindex” [“Shock index”]. Dtsch Med Wochenschr. 1967 27; 92(43):1947–50.
    [Google الباحث العلمي]
  20. Prasad KJD, Bindu KCH, Abhinov T, Moorthy K, Rajesh K. A Comparative study on predictive validity of modified shock index, shock index, and age shock index in predicting the need for mechanical ventilation among sepsis patients in a tertiary care hospital. J Emerg Trauma Shock. 2023 Jan-Mar; 16(1):17–21. doi: 10.4103/jets.jets_118_22.
    [Google الباحث العلمي]
  21. Oduncu AF, Kıyan GS, Yalçınlı S. Comparison of qSOFA, SIRS, and NEWS scoring systems for diagnosis, mortality, and morbidity of sepsis in emergency department. Am J Emerg Med. 2021 Oct;48:54–9. doi: 10.1016/j.ajem.2021.04.006.
    [Google الباحث العلمي]
  22. Dai G, Lu X, Xu F, Xu D, Li P, Chen X, et al. Early mortality risk in acute trauma patients: Predictive value of injury severity score, trauma index, and different types of shock indices. J Clin Med. 2022 Dec 5; 11(23):7219. doi: 10.3390/jcm11237219.
    [Google الباحث العلمي]
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  • نوع المستند: Research Article
الموضوعات الرئيسية age shock indexanion gapmetabolic acidosis and septic shock

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