Shock Index ≥0.976 (AUC 0.882) and Modified Shock Index ≥1.191 (AUC 0.883) strongly predict cardiac tamponade with high sensitivity and specificity.
Do the Shock Index (SI) and Modified Shock Index (MSI) predict the occurrence of cardiac tamponade in patients with pericardial effusion?
Shock Index ≥ 0.976 and Modified Shock Index ≥ 1.191 are strong predictors for the occurrence of cardiac tamponade in patients with pericardial effusion.
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Abstract Objective To evaluate the predictive value of the Shock Index (SI) and Modified Shock Index (MSI) for cardiac tamponade using the Propensity Score Matching (PSM) method. Methods Patients diagnosed with pericardial effusion from January 2008 to December 2024 were enrolled. Based on the occurrence of cardiac tamponade, patients were divided into a tamponade group and a non-tamponade group. PSM was used to match the two groups in a 1:2 ratio. SI and MSI were calculated based on blood pressure and heart rate. Baseline characteristics were compared between the two groups. Multivariate logistic regression analysis was used to identify independent risk factors for cardiac tamponade. The predictive value of SI and MSI for cardiac tamponade was analyzed using Receiver Operating Characteristic (ROC) curves. Results After PSM, 349 patients were included, with 119 in the tamponade group (mean age 58.2 ± 17.7 years, 61 males 51.3%) and 230 in the non-tamponade group (mean age 61.3 ± 18.9 years, 121 males 52.6%). Univariate analysis showed statistically significant differences in age, disease duration, muffled heart sounds, SI, MSI, maximum diastolic pericardial effusion depth, and etiology distribution between the two groups (P 0.05). Multivariate logistic regression analysis identified disease duration(OR = 5.875; 95% CI: 2.657–12.986), SI (OR = 2038.620; 95% CI: 361.324–11502.085), MSI (OR = 364.438; 95% CI: 94.656–1403.136), and maximum diastolic pericardial effusion depth (OR = 1.477; 95% CI: 1.163–1.875) as independent risk factors for cardiac tamponade. ROC analysis showed that the optimal cutoff values for disease duration, SI, MSI, and maximum diastolic pericardial effusion depth were 1.500, 0.976, 1.191, and 2.170, respectively. The areas under the curve (AUC) for predicting cardiac tamponade were 0.713 (95% CI: 0.656–0.771, P 0.001), 0.882 (95% CI: 0.843–0.921, P 0.001), 0.883 (95% CI: 0.844–0.921, P 0.001), and 0.586 (95% CI: 0.524–0.648, P = 0.006), with sensitivities of 56.3%, 72.3%, 79.8%, and 67.2%, and specificities of 78.7%, 91.7%, 84.8%, and 47.4%, respectively. Conclusion SI and MSI can serve as predictive factors for cardiac tamponade, with SI ≥ 0.976 and MSI ≥ 1.191 being the optimal cutoff values for predicting its occurrence. These indicators help identify high-risk patients for cardiac tamponade and provide a basis for patient risk stratification.Multivariate Logistic Regression ROC curves
Zhang et al. (Sat,) reported a other. Shock Index ≥0.976 (AUC 0.882) and Modified Shock Index ≥1.191 (AUC 0.883) strongly predict cardiac tamponade with high sensitivity and specificity.