What question did this study set out to answer?

The study aims to evaluate the predictive value of rSIG for mortality in ICU heatstroke patients compared to other scoring systems.

April 4, 2026Open Access

Predictive value of the reverse shock index multiplied by glasgow coma scale score for mortality in ICU heatstroke patients: a multicenter study

Key Points

The study aims to evaluate the predictive value of rSIG for mortality in ICU heatstroke patients compared to other scoring systems.
Multicenter retrospective study involving 671 heatstroke patients from 83 ICUs.
Calculations of rSIG from GCS, SBP, and HR at ICU admission.
Comparison of predictive performance using ROC curves.
Logistic regression to identify independent risk factors.
Development of a nomogram incorporating key predictors.
Mortality rate in the cohort was 17.88%.
rSIG had the highest AUC of 0.739 compared to SI, GCS, and qSOFA scores.
Independent predictors included prothrombin time, creatinine, lactate, and rSIG.
The nomogram achieved an AUC of 0.80 for prognostic accuracy.
Subgroup analysis confirmed consistent predictive ability of rSIG across different patient groups.

Abstract

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.

Mark Helpful

Bookmark

Relay

View Full Paper