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Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department
Deciding between palliative and overly aggressive therapies for advanced cancer patients who present to the emergency department (ED) with acute issues requires a prediction of their short-term survival. Various scoring systems have previously been studied in hospices or intensive care units, though...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370122/ https://www.ncbi.nlm.nih.gov/pubmed/32646021 http://dx.doi.org/10.3390/ijerph17134904 |
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author | Cheng, Tzu-Heng Sie, Yi-Da Hsu, Kuang-Hung Goh, Zhong Ning Leonard Chien, Cheng-Yu Chen, Hsien-Yi Ng, Chip-Jin Li, Chih-Huang Seak, Joanna Chen-Yeen Seak, Chen-Ken Liu, Yi-Tung Seak, Chen-June |
author_facet | Cheng, Tzu-Heng Sie, Yi-Da Hsu, Kuang-Hung Goh, Zhong Ning Leonard Chien, Cheng-Yu Chen, Hsien-Yi Ng, Chip-Jin Li, Chih-Huang Seak, Joanna Chen-Yeen Seak, Chen-Ken Liu, Yi-Tung Seak, Chen-June |
author_sort | Cheng, Tzu-Heng |
collection | PubMed |
description | Deciding between palliative and overly aggressive therapies for advanced cancer patients who present to the emergency department (ED) with acute issues requires a prediction of their short-term survival. Various scoring systems have previously been studied in hospices or intensive care units, though they are unsuitable for use in the ED. We aim to examine the use of a shock index (SI) in predicting the 60-day survival of advanced cancer patients presenting to the ED. Identified high-risk patients and their families can then be counseled accordingly. Three hundred and five advanced cancer patients who presented to the EDs of three tertiary hospitals were recruited, and their data retrospectively analyzed. Relevant data regarding medical history and clinical presentation were extracted, and respective shock indices calculated. Multivariate logistic regression analyses were performed. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the SI. Nonsurvivors within 60 days had significantly lower body temperatures and blood pressure, as well as higher pulse rates, respiratory rates, and SI. Each 0.1 SI increment had an odds ratio of 1.39 with respect to 60-day mortality. The area under the ROC curve was 0.7511. At the optimal cut-off point of 0.94, the SI had 81.38% sensitivity and 73.11% accuracy. This makes the SI an ideal evaluation tool for rapidly predicting the 60-day mortality risk of advanced cancer patients presenting to the ED. Identified patients can be counseled accordingly, and they can be assisted in making informed decisions on the appropriate treatment goals reflective of their prognoses. |
format | Online Article Text |
id | pubmed-7370122 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-73701222020-07-21 Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department Cheng, Tzu-Heng Sie, Yi-Da Hsu, Kuang-Hung Goh, Zhong Ning Leonard Chien, Cheng-Yu Chen, Hsien-Yi Ng, Chip-Jin Li, Chih-Huang Seak, Joanna Chen-Yeen Seak, Chen-Ken Liu, Yi-Tung Seak, Chen-June Int J Environ Res Public Health Article Deciding between palliative and overly aggressive therapies for advanced cancer patients who present to the emergency department (ED) with acute issues requires a prediction of their short-term survival. Various scoring systems have previously been studied in hospices or intensive care units, though they are unsuitable for use in the ED. We aim to examine the use of a shock index (SI) in predicting the 60-day survival of advanced cancer patients presenting to the ED. Identified high-risk patients and their families can then be counseled accordingly. Three hundred and five advanced cancer patients who presented to the EDs of three tertiary hospitals were recruited, and their data retrospectively analyzed. Relevant data regarding medical history and clinical presentation were extracted, and respective shock indices calculated. Multivariate logistic regression analyses were performed. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the SI. Nonsurvivors within 60 days had significantly lower body temperatures and blood pressure, as well as higher pulse rates, respiratory rates, and SI. Each 0.1 SI increment had an odds ratio of 1.39 with respect to 60-day mortality. The area under the ROC curve was 0.7511. At the optimal cut-off point of 0.94, the SI had 81.38% sensitivity and 73.11% accuracy. This makes the SI an ideal evaluation tool for rapidly predicting the 60-day mortality risk of advanced cancer patients presenting to the ED. Identified patients can be counseled accordingly, and they can be assisted in making informed decisions on the appropriate treatment goals reflective of their prognoses. MDPI 2020-07-07 2020-07 /pmc/articles/PMC7370122/ /pubmed/32646021 http://dx.doi.org/10.3390/ijerph17134904 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cheng, Tzu-Heng Sie, Yi-Da Hsu, Kuang-Hung Goh, Zhong Ning Leonard Chien, Cheng-Yu Chen, Hsien-Yi Ng, Chip-Jin Li, Chih-Huang Seak, Joanna Chen-Yeen Seak, Chen-Ken Liu, Yi-Tung Seak, Chen-June Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department |
title | Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department |
title_full | Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department |
title_fullStr | Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department |
title_full_unstemmed | Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department |
title_short | Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department |
title_sort | shock index: a simple and effective clinical adjunct in predicting 60-day mortality in advanced cancer patients at the emergency department |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370122/ https://www.ncbi.nlm.nih.gov/pubmed/32646021 http://dx.doi.org/10.3390/ijerph17134904 |
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