The usefulness of modified shock index for prediction of postintubation hypotension in emergency department.
- Author:
Junsung JANG
1
;
Kyoungmi LEE
;
Inbyung KIM
;
Hyunjong KIM
;
Jungeon KIM
Author Information
1. Department of Emergency Medicine, Myongji Hospital, Goyang, Korea. jekim1229@naver.com
- Publication Type:Original Article
- Keywords:
Intubation;
Hypotension;
Risk factors;
Mortality;
Emergency medical services;
Hospitals
- MeSH:
Blood Pressure;
Emergencies*;
Emergency Medical Services;
Emergency Service, Hospital*;
Hospital Mortality;
Humans;
Hypotension*;
Intubation;
Intubation, Intratracheal;
Mortality;
Observational Study;
Retrospective Studies;
Risk Factors;
Serum Albumin;
Shock*
- From:Journal of the Korean Society of Emergency Medicine
2018;29(4):358-363
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: Hypotension after emergent endotracheal intubation is a serious complication related to in-hospital mortality. We investigated factors including modified shock index to predict the development of hypotension after emergent intubation. METHODS: This retrospective observational study was conducted between January 2011 and December 2016. The study population included intubated patients among all medical patients admitted to the emergency department (ED) except for patients whose systolic blood pressure was below 90 mmHg at any time before intubation. The postintubation hypotension (PIH) groups were compared with the non-PIH group. The secondary outcome was in-hospital mortality. RESULTS: A total of 285 patients were included in this study, of which 92 patients (32.3%) PIH. The age (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01–1.06; P=0.001), serum albumin level (OR, 0.62; 95% CI, 0.41–0.92; P=0.019), shock index (OR, 3.25; 95% CI, 1.26–8.38; P=0.015), and modified shock index (MSI) (OR, 2.18; 95% CI, 1.06–4.47; P=0.034) were more closely associated with PIH than any other factors. The average survival of the PIH group was significantly shorter than that of the non-PIH group (13.6±3.5 vs. 35.6±12.0, log-rank test P=0.019). CONCLUSION: Overall, 32.3% of hemodynamically stable medical patients developed PIH in ED. MSI was associated with PIH.
