Prognostic value of shock index, modified shock index, respiratory-adjusted shock index, and age shock index in pneumonia

Purpose: The aim of this study was to evaluate shock index (SI), modified SI (mSI), respiratory-adjusted SI (RASI), and age SI (aSI) scores, which are calculated using only age and vital signs, on 30-day mortality in patients presenting to the emergency department (ED) with pneumonia. Materials and Methods: This single-center, prospective cohort study included 378 patients who presented to the ED of Pamukkale University Hospital between February 2023 and January 2024 and were diagnosed with pneumonia. We evaluated the association between their clinicodemographic characteristics, including SI, mSI, RASI, aSI, and ED outcome, which was mortality within 30 days of presentation. Results: 245 (64.8%) of the patients were men, and the mean age was 70.28 ± 12.94 years. The 30-day mortality rate was 23.5% (89/378). Logistic regression analysis revealed SI (odds ratio [OR] = 4.303), mSI (OR = 3.163), RASI (OR = 1.385), and aSI (OR = 1.020); and the presence of sputum or malignancy, blood urea nitrogen levels, and fingertip O2 saturation as valuable predictors of mortality. SI, mSI, RASI and aSI demonstrated moderate predictive performance at their respective cut-off values in the ROC analysis.Conclusion: SI, mSI, RASI, and aSI were each independently associated with increased 30-day mortality among patients presenting to the ED with pneumonia. Additionally, sputum or malignancy, elevated blood urea nitrogen, and reduced fingertip O2 saturation emerged as further predictors of mortality.