Shock Index Correlates with Hospitalization and Mortality in General Emergency Department Patients

The shock index — the ratio of heart rate to systolic blood pressure — has been described primarily in trauma patients to identify those at risk for poor outcomes. In this retrospective study of 58,336 adult general emergency department visits at one urban academic center, researchers reviewed the shock index measured at initial presentation and determined the optimal cutoff for predicting hospitalization and mortality.

A shock index of >1.2 was associated with an increased likelihood of hospital admission (positive likelihood ratio, 12) and inpatient mortality (positive likelihood ratio, 6). This optimal cutoff is notably higher than the previously recommended thresholds of >0.7 and >0.9 described in trauma patients. The shock index in heal…