Use of Shock Index and Lactate to Predict Mortality in Acute Heart Failure Patients in Emergency Department

To compare the usefulness of shock index (SI) and lactate for prediction of 24-hour and 28-day mortality in acute heart failure (AHF) patients.

A descriptive study. Place and Duration of the Study: Balikesir University Hospital, Balikesir, Turkey; from February 2019 to August 2020.

One hundred and twelve AHF patients presenting to ED were recruited into the study. Usefulness of lactate and SI in predicting mortality at 24-hour and 28-day, was evaluated.

The area under the curve (AUC) was found to be 0.825 for lactate and 0.818 for SI in predicting 24-hour mortality. There was significant difference between the diagnostic performances of 2 markers in predicting 24-hour mortality. AUC was found to be 0.775 for lactate and 0.722 for SI in predicting 28-day mortality. No significant difference was found between the diagnostic performances of the two markers in predicting 28-day mortality. The 24-hour non-survivor rates were found to be 86.67% in patients with lactate levels >2.57; 76.47% in patients with SI >0.94, and 93.33% in patients with lactate levels >2.57 or SI >0.94. The 28-day non-survivor rates were found to be 64.71% in patients with lactate levels >2.57; 70.59% in patients with SI >0.82, and 82.35% in patients with lactate levels >2.57 or SI >0.82.

Lactate level and SI of AHF patients calculated in ED triage may be used to predict mortality, and simultaneous use of both parameters may be more helpful. Key Words: Acute heart failure, Emergency department, Lactate, Mortality, Shock index.