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[Relationship between the systolic-diastolic shock index and mortality in myocardial infarction]
Ana Karen Del Socorro Arévalo-Coronado1, Alfonso López-Manríquez1, Martha Alicia Hernández-González2
1Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Urgencias Médicas. León, Guanajuato, México.
Insights
The study found that both the systolic shock index and diastolic shock index are significant prognostic factors for mortality in patients with ST-elevation myocardial infarction. These indices can help predict outcomes before hemodynamic intervention.
Area of Science:
- Cardiology
- Clinical Medicine
- Medical Prognostics
Context:
- The shock index, calculated as heart rate divided by systolic blood pressure, is utilized in emergency settings to assess patient prognosis across various conditions, including acute myocardial infarction.
- Accurate prognostic markers are crucial for managing patients with ST-elevation myocardial infarction (STEMI), particularly those undergoing hemodynamic procedures.
Purpose:
- This study aimed to investigate the relationship between the systolic shock index (SSI) and diastolic shock index (DSI) and their efficacy as prognostic factors for mortality in patients with STEMI admitted for cardiac catheterization.
- To evaluate the predictive value of SSI and DSI for mortality in STEMI patients prior to intervention.
Summary:
- A prolective, cross-sectional study analyzed 162 STEMI patients admitted for cardiac catheterization.
- The diastolic shock index (> 1.2143) demonstrated a sensitivity of 62.5% and specificity of 77.4% (p < 0.05).
- The systolic shock index (> 0.8908) showed a sensitivity of 45.8% and specificity of 91.2% (p < 0.05), indicating their prognostic relevance.
Impact:
- The findings confirm that both SSI and DSI are independently associated with mortality risk in STEMI patients presenting for hemodynamic intervention.
- These indices can serve as valuable, readily available tools for risk stratification and prognosis assessment in the acute care setting.
- Early identification of high-risk patients through shock index calculation may guide timely therapeutic decisions and resource allocation.
Background:
In the emergency room, the shock index was applied to determine the prognosis in various pathologies, such as acute infarction. The shock index is the re-sult of dividing heart rate by the systolic blood pressure.
Objective:
To determine the relationship between the systolic shock index and the di-astolic shock index as prognostic factors for mortality in acute myocardial infarction with ST segment elevation prior to admission to the Hemodynamics Room.
Material And Methods:
A prolective analytical cross-sectional study was carried out in patients who were admitted to the Hemodynamics Room for cardiac catheterization within a period of 5 months in 2022. The systolic shock index and diastolic shock index were included as independent variables and mortality was the dependent variable. SPSS, version 25, was used and Pearson's chi-square test was used as statistical test, with a p value < 0.05 being significant.
Results:
162 patients were analyzed and showed a diastolic shock index > 1.2143 with a sensitivity of 62.5% and a specificity of 77.4% with a p < 0.05. Their systolic shock in-dex was > 0.8908 with a sensitivity of 45.8% and specificity of 91.2%, with a p < 0.05.
Conclusion:
It was determined that both shock indices are related as mortality prognos-tic factors in acute myocardial infarction with ST elevation prior to admission to the He-modynamic Room.
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