Evaluation of modified shock index and mortality rate of patients at Emergency Department of tertiary care hospital in Tamil Nadu
Journal Title: International Archives of Integrated Medicine - Year 2017, Vol 4, Issue 11
Abstract
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.
Authors and Affiliations
T. Bhuvanenswari, B. Devaraj
Keywords
Related Articles
- EP ID EP411603
- DOI -
- Views 101
- Downloads 0
A study of waist hip ratio in identifying cardiovascular risk factors at Government Dharmapuri College Hospital
Introduction: Rising incidence of Diabetes mellitus, Systemic hypertension and Dyslipidemia, the well-known risk factor for cardiovascular disease is the leading cause for increased incidence of cardiovascular diseases1....
Peters anomaly with post axial polydactyly, ocular hypertelorism, a low nasal bridge, retrognathia, undescended testis, microphthalmia, and club foot in an Indian neonate: A case report
A case of Peters anomaly with bilateral post axial polydactyly, convex soles, ocular hypertelorism, a low nasal bridge, retrognathia, undescended testis, microphthalmia and club foot was examined in a neonatal Indian bab...
A clinical study of post-operative complications of emergency and elective (open and laparoscopic) appendicectomy
Background: Post-operative complications which follows appendicectomy are not common and it reflect the level of peritonitis that is present during the time of surgery and the diseases which may be predisposed to complic...
Ovarian tumors - Incidence and histopathological spectrum in tertiary care center, Valsad
Introduction: Ovarian tumors are now the one of the leading cause of death involving a wide spectrum of clinical, morphological and histopathological diagnosis. It frequently does not result in symptoms until the tumor h...
Sustained ventricular tachycardia (VT) in coronary artery disease (CAD): A study from tertiary care center in north India
Background: Ventricular Tachycardia (VT) constitutes an important manifestation of coronary artery disease (CAD). VT can occur in the immediate acute myocardial infarction (MI) period, further complicating the management...