Comparison of the ability of the shock index, modified shock index and age shock index to predict mortality in geriatric patients with COVID-19 pneumonia

Abstract

ÖZET Giriş: COVID-19 pnömonisi olan yaşlı hastalarda hastalığın ciddiyetini ve mortalitesini erken bir aşamada tahmin etmek için acilen bir prognostik ölçüme ihtiyaç vardır. Amacımız, COVID 19 pnömonisi olan ileri yaştaki hastalarda mortalitenin erken tahmininde şok, modifiye şok ve yaş şok indeksinin rolünü araştırmaktı. Gereç ve yöntem: Çalışmaya, pozitif RT-PCR testi ile doğrulanmış COVID-19 pnömonisi olan 65 yaş üstü hastalar dahil edildi. Dahil edilen tüm hastalar için her üç indeks de hesaplandı. Mortaliteyi belirlemede indekslerin prediktif değerlerini belirlemek için ROC analizi kullanıldı. Bulgular: Dahil etme ve hariç tutma kriterleri değerlendirildikten sonra toplam 134 hasta ile çalışma tamamlandı. Mortaliteyi öngörmede şok indeksi ve yaş şok indeksinin istatistiksel olarak anlamlı farklılık göstermediği bulundu (sırasıyla p=0.23 ve p=0.06). Mortaliteyi tahmin etmede modifiye şok indeksinin ROC analizinde eğrinin altında kalan alan 0.658 (%95 CI 0.572-0.738) ve Youden indeksi 0.35 (p=0.02) idi. Daha yüksek modifiye şok indeks değerlerine sahip vakaların, düşük değerlere sahip olanlara göre ölümle sonuçlanma olasılığı 86 kat daha fazla bulundu. Sonuç: Modifiye şok indeksi, RT-PCR ve tomografi ile doğrulanmış COVID-19 pnömonisi olan 65 yaş üstü hastalarda acil serviste triyaj sırasında mortaliteyi tahmin etmek için kullanılabilecek hızlı, basit ve etkili bir yöntemdir. Anahtar kelimler: Koronavirüs, Kovid-19, Modifiye şok indeksi, Şok indeksi, Yaş şok indeksi ABSTRACT Introduction: A prognostic measure is urgently needed to predict the severity and mortality of the disease at an early stage in elderly patients with COVID-19 pneumonia. We aimed determine the shock, modified shock and age shock indexes in the early prediction of mortality in advanced-age patients with COVID 19 pneumonia. Material and Method: The study included patients over 65 years of age with COVID-19 pneumonia confirmed with a positive RT-PCR test. All three indexes were calculated for all the included patients. The ROC analysis was used to determine the predictive values of the indexes in determining mortality. Results: After evaluating the inclusion and exclusion criteria, the study was completed with a total of 134 patients. It was found that the shock index and age shock index did not statistically significantly differ in predicting mortality (p=0.23 and p=0.06, respectively). In the ROC analysis of the modified shock index in predicting mortality, the area under the curve was 0.658 (95% CI 0.572-0.738) and the Youden index was 0.35 (p=0.02). Cases with higher modified shock index values were found to be 86 times more likely to result in mortality than those with lower values. Conclusion: The modified shock index is a fast, simple and effective method that can be used to predict mortality during triage in the emergency department in patients aged over 65 with COVID-19 pneumonia confirmed by RT-PCR and tomography. DESIGN: Observational, retrospective medical record review. Keywords: Age shock index, Coronavirus, Covid-19, Modified shock index, pneumonia, shock index

Keywords

• age shock index
• coronavirus
• covid-19
• modified shock index
• pneumonia
• shock index

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