Correlation Between Age Shock Index and Perfusion Index with Emergency Severity Index and Its Predictive Value of In-Hospital Mortality

INTRODUCTION: Perfusion index (PI), shock index (SI), modified shock index (MSI), and age shock index (ASI) are valuable markers used to predict the clinical course and mortality of patients in various intensive care units and emergency departments (ED). We investigated the relationship between these markers and emergency severity index (ESI) and their value in predicting in-hospital mortality.
METHODS: In this prospective, cross-sectional, single-centered study, the vital values of the patients and the perfusion index were measured and categorized according to ESI. The correlation between shock, modified shock, age shock indices, and PI among the ESI categories and their predictive values for in-hospital mortality were calculated.
RESULTS: We established statistically significantly lower perfusion index values and significantly higher values in the age shock index in the group with in-hospital mortality compared to survivors (p=0.001, <0.001, respectively). The AUC score for in-hospital mortality of the perfusion index of 0,723 and age severity index are 0.723 and 0.807, respectively. The specificity of PI and the sensitivity of ASI are 91.62% and 91.67%, respectively, and negative predictive values of those are 98.66% and 99.67%, respectively.
DISCUSSION AND CONCLUSION: Adding PI and ASI to existing triage scores, such as ESI, may improve triage specificity in unselected patients who are admitted to the emergency department.