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ABSTRACT: Background
To improve outcomes for patients who present to hospital with suspected sepsis, it is necessary to accurately identify those at high risk of adverse outcomes as early and swiftly as possible. To assess the prognostic accuracy of shock index (heart rate divided by systolic blood pressure) and its modifications in patients with sepsis or community-acquired pneumonia.Methods
An electronic search of MEDLINE, EMBASE, Allie and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Open Grey, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (WHO ITRP) was conducted from conception to 26th March 2019. Eligible studies were required to assess the prognostic accuracy of shock index or its modifications for outcomes of death or requirement for organ support either in sepsis or pneumonia. The methodological appraisal was carried out using the Downs and Black checklist. Evidence was synthesised using a narrative approach due to heterogeneity.Results
Of 759 records screened, 15 studies (8697 patients) were included in this review. Shock index ? 1 at time of hospital presentation was a moderately accurate predictor of mortality in patients with sepsis or community-acquired pneumonia, with high specificity and low sensitivity. Only one study reported outcomes related to organ support.Conclusions
Elevated shock index at time of hospital presentation predicts mortality in sepsis with high specificity. Shock index may offer benefits over existing sepsis scoring systems due to its simplicity.
SUBMITTER: Middleton DJ
PROVIDER: S-EPMC6723191 | biostudies-literature | 2019 Jul
REPOSITORIES: biostudies-literature
Middleton David J DJ Smith Toby O TO Bedford Rachel R Neilly Mark M Myint Phyo Kyaw PK
Journal of clinical medicine 20190731 8
<h4>Background</h4>To improve outcomes for patients who present to hospital with suspected sepsis, it is necessary to accurately identify those at high risk of adverse outcomes as early and swiftly as possible. To assess the prognostic accuracy of shock index (heart rate divided by systolic blood pressure) and its modifications in patients with sepsis or community-acquired pneumonia.<h4>Methods</h4>An electronic search of MEDLINE, EMBASE, Allie and Complementary Medicine Database (AMED), Cumulat ...[more]