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Shock index creatinine: a new predictor of mortality in acute coronary syndrome patients
Widuri Wita Andriati Shariefuddin1, Miftah Pramudyo2, Januar Wibawa Martha2
1Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia. widuriwita@gmail.com.
Insights
The Shock Index Creatinine (SIC) score effectively predicts in-hospital mortality in Acute Coronary Syndrome (ACS) patients. A score of 25 or higher indicates significantly increased mortality risk, offering valuable prognostic information.
Area of Science:
- Cardiology
- Critical Care Medicine
- Medical Diagnostics
Background:
- The Shock Index Creatinine (SIC) score is a novel tool for patient risk stratification.
- While used in ST-Elevation Myocardial Infarction (STEMI), its utility in Acute Coronary Syndrome (ACS) requires further evaluation.
- Predicting in-hospital mortality in ACS patients is crucial for timely intervention.
Purpose of the Study:
- To evaluate the utility of the SIC score in predicting in-hospital mortality among ACS patients.
- To update the current SIC score for improved risk stratification in ACS.
- To assess the SIC score's performance across the entire spectrum of ACS.
Main Methods:
- A retrospective, single-centered cohort study included 1349 adult ACS patients.
- Data were collected between January 2018 and January 2022.
- In-hospital mortality was analyzed using binary logistic regression and ROC curve analysis.
Main Results:
- Multivariate analysis confirmed a significant association between SIC score and in-hospital mortality (p < 0.001).
- A high SIC score (≥25) was linked to a 2.655-fold increased odds of in-hospital mortality.
- The SIC score demonstrated acceptable predictive value (AUC = 0.789) with optimal sensitivity (71.5%) and specificity (74.4%) at a cutoff of ≥25.
Conclusions:
- The SIC score is a valuable tool for predicting in-hospital mortality in patients across all ACS spectrums.
- A SIC score of 25 or higher is particularly indicative of increased mortality risk.
- This study is the first to comprehensively evaluate the SIC score in the full range of ACS patients.
Background:
The Shock Index Creatinine (SIC) scoring is a recently developed tool for risk stratification patients. These updated scoring was already used in ST-Elevation Myocardial Infarction (STEMI) patients. However its utility in predicting outcomes for patients with Acute Coronary Syndrome (ACS) remains unclear. This study aims to evaluate and update the current SIC score to predict in-hospital mortality among patients with ACS.
Patients And Methods:
A retrospective cohort, Single-centered study enrolled 1349 ACS patients aged ≥ 18 years old diagnosed with ACS was conducted between January 2018 to January 2022 who met for inclusion and exclusion criteria. Study subjects were analyzed for in-hospital mortality and evaluated using binary linear regression analysis. The area under the curve (AUC) of SIC score was obtain to predict the sensitivity and specificity.
Results:
Multivariate analysis showed that SIC score was significantly associated with in-hospital mortality. High SIC score (SIC ≥ 25) had significantly higher in-hospital mortality (p < 0.001) with odds ratio for (95% CIs) were 2.655 (1.6-4.31). Receiver operating characteristics (ROC) curve analysis determine the predictive power of SIC score for in-hospital mortality. SIC had an acceptable predictive value for in-hospital mortality (AUC = 0.789, 95% CI: 0.748-0.831, p < 0.001). The SIC score for sensitivity and specificity were, respectively, 71.5% and 74.4%, with optimal cutoff of SIC ≥ 25.
Conclusion:
SIC had acceptable predictive value for in-hospital mortality in patients with all ACS spectrums. SIC was a useful parameter for predicting in-hospital mortality, particularly with a score ≥ 25. This is the first study to evaluate SIC in all spectrums of ACS.
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