Shock index for outcome and risk stratification in acute pulmonary embolism✩

Karsten Keller; Meike Coldewey; Martin Geyer; Johannes Beule; Jörn Oliver Balzer; Wolfgang Dippold

doi:10.1016/j.artres.2016.05.002

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Volume 15, Issue C, September 2016, Pages 30 - 35

Shock index for outcome and risk stratification in acute pulmonary embolism✩

Authors

Karsten Keller^a^{, b}^{, *}, Meike Coldewey^a^{, b}, Martin Geyer^a, Johannes Beule^c, Jörn Oliver Balzer^d^{, e}^{, f}, Wolfgang Dippold^c^{, f}

^aCenter of Cardiology, Cardiology I, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany

^bCenter for Thrombosis and Hemostasis, University Medical Center Mainz (Johannes Gutenberg-University Mainz), Mainz, Germany

^cDepartment of Internal Medicine, St. Vincenz and Elisabeth Hospital Mainz (KKM), Mainz, Germany

^dDepartment of Radiology and Nuclear Medicine, Catholic Clinic Mainz (KKM), Mainz, Germany

^eDepartment of Diagnostic and Interventional Radiology, University Clinic, Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt (Main), Germany

^✩

The study was conducted in St. Vincenz and Elisabeth Hospital Mainz (KKM).

^f

Both authors were co-shared last authors.

^*Corresponding author. Center of Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany. Tel.: +49 6131 17 8380; fax: +49 6131 17 8461. E-mail address: Karsten.Keller@unimedizin-mainz.de (K. Keller).

The study was conducted in St. Vincenz and Elisabeth Hospital Mainz (KKM).

Both authors were co-shared last authors.

Corresponding Author

Karsten Keller

Received 15 April 2016, Revised 6 May 2016, Accepted 20 May 2016, Available Online 7 June 2016.

DOI: 10.1016/j.artres.2016.05.002 How to use a DOI?
Keywords: Shock index; Tachycardia; Blood pressure; Thrombosis; Embolism; Right ventricular dysfunction
Abstract: Introduction: Risk stratification of patients with acute pulmonary embolism (PE) is crucial in deciding appropriate therapy management. Shock index (SI) is rapidly available and a reliable parameter. We aimed to investigate SI for short term outcome in acute PE.

Materials and methods: Data of 182 patients with acute PE were analysed retrospectively. SI was defined as heart rate divided by systolic blood pressure. Logistic regression models were calculated to investigate associations between SI and in-hospital-death, myocardial necrosis and presence of right ventricular dysfunction (RVD) respectively. Moreover ROC curves and cut-off values for SI predicting in-hospital death, myocardial necrosis and RVD were computed.

Results: 182 patients (61.5% female, mean age 68.5 ± 15.3 years) with acute PE event were included in the study. 5 patients (2.7%) died an in-hospital death.

Logistic regression models revealed an association between SI and respectively in-hospital death (OR 5.854, 95% CI 1.876–18.274, P = 0.00234), myocardial necrosis (OR 5.043, 95% CI 1.362–18.674, P = 0.0154) and RVD (OR 53.539, 95% CI 6.810–420.914, P = 0.000155).

ROC analysis for SI predicting in-hospital death, myocardial necrosis and RVD revealed an AUC of 0.806, 0.636 and 0.713 respectively with respectively SI cut-off values of 0.89, 0.75 and 0.54.

Conclusions: SI is a significant predictor of in-hospital death, myocardial necrosis and RVD. The effectiveness of SI to predict in-hospital death is high with an optimal cut-off value of 0.89 for differentiation between PE patients with lower and higher risk to die in hospital after acute PE event.
Open Access: This is an open access article distributed under the CC BY-NC license.

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<Previous Article In Issue

Journal: Artery Research
Volume-Issue: 15 - C
Pages: 30 - 35
Publication Date: 2016/06/07
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2016.05.002 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - Karsten Keller
AU  - Meike Coldewey
AU  - Martin Geyer
AU  - Johannes Beule
AU  - Jörn Oliver Balzer
AU  - Wolfgang Dippold
PY  - 2016
DA  - 2016/06/07
TI  - Shock index for outcome and risk stratification in acute pulmonary embolism✩
JO  - Artery Research
SP  - 30
EP  - 35
VL  - 15
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.05.002
DO  - 10.1016/j.artres.2016.05.002
ID  - Keller2016
ER  -

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