title: Shock index, modified shock index, and age shock index for prediction of mortality in Emergency Severity Index level 3.
abstract: OBJECTIVE
  To elucidate the predictive capability of shock index (SI), modified SI (MSI), and age SI for mortality in patients assigned to Emergency Severity Index (ESI) level 3 patients.
  
  
  METHODS
  This was a retrospective medical record review performed in an academic internal medicine emergency department in Kerman, Iran. All patients older than 14 years triaged to ESI level 3 were enrolled in the study. Triage time vital signs were used to calculate SI, MSI, and age SI. The primary outcome was in-hospital mortality.
  
  
  RESULTS
  A total number of 3375 patients were enrolled in the study, in which 84 (2.5%) died during hospital stay. In the adjusted multivariate analysis, age SI, systolic blood pressure (SBP), and sex were independently associated with mortality, with P values (odds ratio [95% confidence interval]) of <.001 (1.03 [1.01-1.04]), .003 (0.97 [0.96-0.99]), and .04 (1.61 [1.01-2.59]), respectively. Receiver operating characteristic curve showed an area under curve of 0.717 for the 3-variable final model and an area under curve of 0.678 for age SI in mortality prediction.
  
  
  CONCLUSIONS
  In ESI level 3 patients, age SI and SBP showed to be better than SI or MSI in predicting mortality. However, because their predictive capability was modest, age SI or SBP should be considered adjuncts to sort actions in favor of patients with higher risk for mortality.
authors.affiliation: Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran; Clinical Research Center, Afzalipoor Hospital, Kerman, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Torabi
authors.affiliation: Clinical Research Center, Afzalipoor Hospital, Kerman, Iran.
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Moeinaddini
authors.affiliation: Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran. Electronic address: a.mirafzal@yahoo.com.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Mirafzal
authors.affiliation: Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Azam
authors.initials: A
authors.lastname: Rastegari
authors.affiliation: Clinical Research Center, Afzalipoor Hospital, Kerman, Iran.
authors.forename: Neda
authors.initials: N
authors.lastname: Sadeghkhani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001794:Blood Pressure; D004636:Emergency Service, Hospital; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012769:Shock / Q000401:mortality*; D013599:Systole; D014218:Triage; D055815:Young Adult