Key result
Age shock index (ASI) was the most effective derivative for predicting mortality in STEMI patients (AUC 0.802), while age-modified shock index (AMSI) excelled in predicting major adverse cardiovascular events.
Why the study?
The study evaluated the success of the shock index and its derivatives for rapid prognosis and risk assessment in patients presenting with STEMI to the emergency department.
Observational (n=467)
No
Effect estimate: AUC 0.802 (95% CI 0.749-0.855)
p-value: p=<0.001
May enhance early risk stratification in STEMI; hypothesis-generating and requires prospective validation before practice change.
Objectives: The shock index (SI) and its derivatives play a crucial role in rapid prognosis and risk assessment, particularly in emergent scenarios like ST-segment elevation myocardial infarction (STEMI). Methods: This study was conducted as a single-centered retrospective. A total of 467 cases that met the study criteria with a confirmed STEMI diagnosis were included. The SI, modified SI (MSI), age SI (ASI), and age-modified SI (AMSI) scores of the cases were calculated and compared. In this study, p 0.05 was accepted as the statistical significance level. Results: Calculated scores were compared among cases meeting STEMI criteria. Mortal cases displayed significantly higher SI, MSI, ASI, and AMSI, as well as elevated heart rates and lowered SBP, DBP, and MAP values. ASI exhibited the highest predictive success for mortality (AUC: 0.802), followed by AMSI (AUC: 0.798). AMSI demonstrated superior significance in estimating major adverse cardiovascular events (MACE) (p < 0.001 for each parameter). Conclusions: ASI proved most effective in gauging mortality risk, while AMSI excelled in predicting MACE risk among SI derivatives. These indices hold promise for guiding patient triage and emergency care in STEMI cases, owing to their simplicity and predictive capacity.
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Yurtsever et al. (2023) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=467). Age shock index (ASI) vs. Other shock index derivatives (SI, MSI, AMSI) was evaluated on Mortality prediction (AUC 0.802, 95% CI 0.749-0.855, p=<0.001). Age shock index (ASI) was the most effective derivative for predicting mortality in STEMI patients (AUC 0.802), while age-modified shock index (AMSI) excelled in predicting major adverse cardiovascular events.
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