PeerJ Reviewer Match - Shock indices to predict acute HF

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Performance of shock indices in predicting acute heart failure mortality: A systematic review and meta-analysis

Abstract

Background: The shock index (SI), along with its derivatives, the modified shock index (MSI), age shock index (ASI), and age-modified shock index (AMSI), have been reported to predict mortality in patients with acute heart failure (AHF). This review aimed to examine the association between SI, MSI, ASI, and AMSI and mortality, as well as their predictive performance in patients with AHF.

Methods: An electronic search was conducted across seven databases. A random-effects model meta-analysis was used to estimate the odds ratios, sensitivities, and specificities of the shock indices. A bivariate model was used to generate summary receiver operating characteristic (sROC) curves and the corresponding area under the curve (AUC) values.

Results: The systematic review included 10 studies with 22,609 patients. Patients with high SI, MSI, ASI, or AMSI had higher odds of in-hospital mortality (OR for SI, MSI, ASI, and AMSI = 2.4, 2.2, 2.7, and 2.7, respectively). High SI was also associated with a fourfold increase in the odds of 28-day mortality. In terms of predictive performance, MSI was found to be the most specific marker (specificity, 67.6%), whereas AMSI was the most sensitive predictor (sensitivity, 65.7%) of in-hospital mortality. The SI performed better in predicting the 28-day mortality (sensitivity, 69.2%; specificity, 69.6%). ASI had the highest AUC at 0.66, whereas the AUCs of SI, MSI, and AMSI were equal at 0.63.

Conclusions: SI and its derivatives are simple predictive tools for assessing mortality risk in patients with AHF.

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