Evaluation of modified shock index and mortality rate of patients at Emergency Department of tertiary care hospital in Tamil Nadu

Introduction: A number of systems or alerts are implemented in the ED to identify and bring resources to patients with traumatic injuries, ST-elevation myocardial infarctions, or acute strokes, but there is currently no system that we are aware of directed toward vital sign abnormalities. Rapid response teams (RRT) or medical emergency teams were created in many in-hospital settings as an effective mechanism to get physicians and nurses to the bedside of patients with acute changes in clinical stability. They were based on physiological criteria as well as a change in clinical status. The aim of the study: To determine whether modified shock index (MSI) is associated with mortality that is superior to heart rate, blood pressure, or the shock index (SI) in emergency patients. Materials and methods: The study was conducted on 80 patients who presented to Saveetha Institute of Medical Science and Hospital, Emergency Department from March to August 2017. We gathered data of the patients on age, gender, vital signs, levels of consciousness, presenting complaints, and SI and MSI were calculated for all patients. Results: After adjustments for differences in the other vital signs, comorbidities, gender and age the following vital signs were independently associated with1-day mortality: oxygen saturation, systolic blood pressure, temperature, level of consciousness, respiratory rate, pulse rate, and age. The highest odds ratios were observed when comparing unresponsive to alert patients (OR 31.0, CI 16.9 to 56.8), patients ≥ 80 years to <50 years (OR 35.9, CI 10.7 to 120.2) and patients with respiratory rates <8/min to 8–25/min (OR 18.1, CI 2.1 to 155.5). Conclusion: MSI is a clinically significant predictor of mortality in emergency patients. It may be better than using heart rate and blood pressure alone. SI is not significantly correlated with the mortality rate of the emergency patient. MSI is an important predictor of mortality in patients presenting to the emergency department and it may be better than blood pressure and heart rate. SI is not significantly correlated with the mortality of emergency patients. When a patient with normal vital signs on the triage desk, MSI can be calculated to decide whether the condition of the patients is critical. Since this is a retrospective study, a prospective study is needed to confirm the result.