Predicting Septic Shock in Patients with Sepsis at Emergency Department Triage Level Using Systolic and Diastolic Shock Index
Authors: Yumin Jeon, Sungjin Kim, Sejoong Ahn, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sukyo Lee
Published in: American Journal of Emergency Medicine, 2024 January 29
Conclusion:
- SI and DSI at ED triage are significant predictors of progression to septic shock in patients with sepsis.
- The study suggests a practical approach for stratifying sepsis patients at ED triage into low, intermediate, and high risk of progressing to septic shock, potentially facilitating more targeted monitoring and intervention.
Method:
- Observational study using a prospectively collected sepsis registry.
- Primary outcome: Progression to septic shock.
- Secondary outcomes: Time to vasopressor requirement, vasopressor dose, and severity based on SI and DSI.
- Patients categorized into tertiles based on the first principal component analysis of SI and DSI.
Results:
- 1267 patients were included.
- Area under the receiver operating characteristic curve (AUC) for DSI predicting septic shock was 0.717, and for SI was 0.707, both outperforming conventional early warning scores.
- Middle tertile had an adjusted odds ratio (aOR) of 1.448 for progression to septic shock, while the upper tertile had a significantly higher aOR of 3.704.