Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Settings and Subjects
2.3. Measurement of Variables
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Patients | p-Value | ||
---|---|---|---|---|
Total | Survivors | Nonsurvivors | ||
No. | 305 | 117 | 188 | |
Age | 63.50 ± 13.29 | 65.10 ± 12.42 | 62.51 ± 13.74 | 0.0971 |
Male | 195 (63.93) | 71 (60.68) | 124 (65.96) | 0.4179 |
Primary cancer | ||||
Thyroid cancer | 2 (0.66) | 2 (1.71) | 0.1464 | |
Hypopharyngeal cancer | 13 (4.26) | 8 (6.84) | 5 (2.66) | 0.0885 |
Lung cancer | 86 (28.20) | 34 (29.06) | 52 (27.66) | 0.8939 |
Oropharyngeal cancer | 10 (3.28) | 3 (2.56) | 7 (3.72) | 0.7464 |
Nasopharyngeal cancer | 8 (2.62) | 5 (4.27) | 3 (1.60) | 0.2675 |
Oesophageal cancer | 17 (5.57) | 5 (4.27) | 12 (6.38) | 0.6001 |
Gastric cancer | 29 (9.51) | 9 (7.69) | 20 (10.64) | 0.5143 |
Colon cancer | 43 (14.10) | 17 (14.53) | 26 (13.83) | 0.9987 |
Rectal cancer | 16 (5.25) | 5 (4.27) | 11 (5.85) | 0.7363 |
Bladder cancer | 4 (1.31) | 1 (0.85) | 3 (1.60) | 0.9700 |
Renal cancer | 6 (1.97) | 2 (1.71) | 4 (2.13) | 0.7981 |
Prostate cancer | 7 (2.30) | 3 (2.56) | 4 (2.13) | 0.8045 |
Cervical cancer | 4 (1.31) | 1 (0.85) | 3 (1.60) | 0.9716 |
Uterine cancer | 3 (0.98) | 3 (1.60) | 0.2883 | |
Ovarian cancer | 3 (0.98) | 1 (0.85) | 2 (1.06) | 0.8500 |
Brain cancer | 2 (0.66) | 2 (1.71) | 0.1464 | |
Pancreatic cancer | 12 (3.93) | 4 (3.42) | 8 (4.26) | 0.9501 |
Hepatic cell cancer | 21 (6.89) | 7 (5.98) | 14 (7.45) | 0.7961 |
Cholangial cancer | 8 (2.62) | 4 (3.42) | 4 (2.13) | 0.4883 |
Breast cancer | 17 (5.57) | 7 (5.98) | 10 (5.32) | 0.8059 |
Soft tissue cancer | 6 (1.97) | 6 (3.19) | 0.0857 | |
Previous treatment | ||||
Chemotherapy | 255 (83.61) | 98 (83.76) | 157 (83.51) | 0.9543 |
Radiotherapy | 157 (51.48) | 57 (48.72) | 100 (53.19) | 0.5207 |
Target therapy | 90 (29.51) | 37 (31.62) | 53 (28.19) | 0.6100 |
Surgical treatment | 158 (51.80) | 61 (52.14) | 97 (51.60) | 0.9267 |
Comorbidities | ||||
Diabetes mellitus | 69 (22.62) | 25 (21.37) | 44 (23.40) | 0.7851 |
Hypertension | 97 (31.80) | 44 (37.61) | 53 (28.19) | 0.1117 |
Cerebrovascular accident | 9 (2.95) | 4 (3.42) | 5 (2.66) | 0.9736 |
Heart failure | 5 (1.64) | 1 (0.85) | 4 (2.13) | 0.6525 |
Coronary artery disease | 14 (4.59) | 4 (3.42) | 10 (5.32) | 0.6243 |
Chronic obstructive pulmonary disease | 16 (5.25) | 3 (2.56) | 13 (6.91) | 0.1636 |
End stage renal disease | 6 (1.97) | 2 (1.71) | 4 (2.13) | 0.7981 |
Liver cirrhosis | 25 (8.20) | 7 (5.98) | 18 (9.57) | 0.3696 |
Variable | Patient | |||||||
---|---|---|---|---|---|---|---|---|
Total | Survivors | Nonsurvivors | p-Value | Univariate OR (95% CI) | Multiple OR ** (95% CI) | |||
No. | 305 | 117 | 188 | |||||
Body temperature (℃) * | 36.77 ± 1.32 | 37.11 ± 1.33 | 36.6 ± 1.27 | 0.0006 | 0.73 | (0.61, 0.87) | ||
Pulse rate (/min) * | 110.31 ± 21.17 | 102.40 ± 19.55 | 115.30 ± 20.67 | <0.0001 | 1.03 | (1.02, 1.05) | ||
Respiratory rate (/min) * | 22.53 ± 5.49 | 21.10 ± 4.30 | 23.41 ± 5.96 | 0.0006 | 1.1 | (1.04, 1.16) | ||
Systolic blood pressure (mmHg) * | 104.82 ± 20.91 | 114.50 ± 22.01 | 98.81 ± 17.77 | <0.0001 | 0.96 | (0.95, 0.97) | ||
Mean arterial pressure (mmHg) * | 77.57 ± 16.13 | 83.61 ± 16.31 | 73.82 ± 14.87 | <0.0001 | 0.96 | (0.95, 0.98) | ||
Shock index * | 1.11 ± 0.35 | 0.92 ± 0.27 | 1.21 ± 0.35 | <0.0001 | 1.37 | (1.24, 1.51) | 1.39 | (1.24, 1.55) |
Optimal Cut-Off | Accuracy Rate | Sen | Sp | PPV | NPV | False +ve | False −ve |
---|---|---|---|---|---|---|---|
0.94 | 73.11% | 81.38% | 59.83% | 76.50% | 66.67% | 15.26% | 11.54% |
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Cheng, T.-H.; Sie, Y.-D.; Hsu, K.-H.; Goh, Z.N.L.; Chien, C.-Y.; Chen, H.-Y.; Ng, C.-J.; Li, C.-H.; Seak, J.C.-Y.; Seak, C.-K.; et al. Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department. Int. J. Environ. Res. Public Health 2020, 17, 4904. https://doi.org/10.3390/ijerph17134904
Cheng T-H, Sie Y-D, Hsu K-H, Goh ZNL, Chien C-Y, Chen H-Y, Ng C-J, Li C-H, Seak JC-Y, Seak C-K, et al. Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department. International Journal of Environmental Research and Public Health. 2020; 17(13):4904. https://doi.org/10.3390/ijerph17134904
Chicago/Turabian StyleCheng, Tzu-Heng, Yi-Da Sie, Kuang-Hung Hsu, Zhong Ning Leonard Goh, Cheng-Yu Chien, Hsien-Yi Chen, Chip-Jin Ng, Chih-Huang Li, Joanna Chen-Yeen Seak, Chen-Ken Seak, and et al. 2020. "Shock Index: A Simple and Effective Clinical Adjunct in Predicting 60-Day Mortality in Advanced Cancer Patients at the Emergency Department" International Journal of Environmental Research and Public Health 17, no. 13: 4904. https://doi.org/10.3390/ijerph17134904