Heatstroke has high mortality, requiring early risk stratification. This study aimed to compare the predictive value of the reverse shock index multiplied by Glasgow Coma Scale score (rSIG) with shock index (SI), GCS, and qSOFA score for mortality in ICU heatstroke patients. The reverse shock index multiplied by Glasgow Coma Scale score (rSIG), calculated as GCS × (SBP / HR) using the first recorded values at ICU admission. This multicenter retrospective study included 671 heatstroke patients from 83 ICUs. Predictive performance was compared using receiver operating characteristic (ROC) curves. Independent risk factors were identified via logistic regression, and a nomogram was developed. Subgroup analysis was conducted to assess the consistency of the predictive value of rSIG. The mortality rate was 17.88%. rSIG demonstrated the highest predictive ability (AUC = 0.739), outperforming SI, GCS, and qSOFA. Prothrombin time, creatinine, lactate, and rSIG were independent predictors. The nomogram integrating these factors achieved an AUC of 0.80. Subgroup analysis confirmed the consistent predictive value of rSIG across various patient subgroups. The rSIG is a simple and effective early screening tool for rapid risk stratification in ICU patients with heatstroke. The predictive model combining rSIG with PT, Cr, and Lac further enhances prognostic accuracy, offering significant clinical utility.
Shi et al. (Thu,) studied this question.