Modified Shock Index as a Predictor of Mortality in Patients with Septic Shock in the Emergency Department

Introduction: The Modified Shock Index (MSI) is a rapid, cost-effective, and reproducible tool for identifying patients at risk of septic shock and multiorgan failure. Up to 2% of cases progress to septic shock, with a mortality rate of 90%. Early detection is crucial to prevent progression to multiorgan failure. Objective: To evaluate the usefulness of the MSI as a predictor of in-hospital mortality in patients with septic shock treated at the High Specialty Hospital. Material and methods: Observational, cross-sectional, retrospective, and analytical study. A total of 102 medical records of septic shock patients seen in the emergency department over five years were analyzed. Vital signs, infectious focus, comorbidities, Modified Shock Index calculation, and patient outcomes were recorded. Data were processed in SPSS V.25, obtaining measures of central tendency, dispersion, standard deviation, and Chi-square test (p<0.05). Results: Fifty-two men and 49 women were included. Pulmonary infection was the most frequent focus (55%), and diabetes mellitus was the most common comorbidity. There were 86 deaths, 56 of them with MSI >1.3 (p<0.001, OR=3.47, 95% CI). Conclusions: An MSI greater than 1.3 is associated with an increased risk of mortality in patients with septic shock, tripling the risk compared to those with MSI <1.29.