scholarly journals Equivalency between the shock index and subtracting the systolic blood pressure from the heart rate: An observational cohort study

2020 ◽  
Author(s):  
Yohei Kamikawa ◽  
Hiroyuki Hayashi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Correlation Coefficient ◽  
Observational Cohort Study ◽  
Regression Equation ◽  
Shock Index ◽  
Observational Cohort

Abstract Background: Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index.Methods: This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged < 15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency.Results: Among 5,429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P < .001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005).Conclusion: The simple shock index strongly correlated with the shock index.

scholarly journals Equivalency between the shock index and subtracting the systolic blood pressure from the heart rate: an observational cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yohei Kamikawa ◽  
Hiroyuki Hayashi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Correlation Coefficient ◽  
Observational Cohort Study ◽  
Regression Equation ◽  
Shock Index ◽  
Observational Cohort

Abstract Background Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index. Methods This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged < 15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency. Results Among 5429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P < .001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005). Conclusion The simple shock index strongly correlated with the shock index.

scholarly journals Equivalency Between the Shock Index and Subtracting the Systolic Blood Pressure From the Heart Rate: An Observational Cohort Study

2020 ◽  
Author(s):  
Yohei Kamikawa ◽  
Hiroyuki Hayashi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Correlation Coefficient ◽  
Observational Cohort Study ◽  
Regression Equation ◽  
Shock Index ◽  
Observational Cohort

Abstract Background: Although the shock index is known to predict mortality and other severe outcomes, deriving it requires complex calculations. Subtracting the systolic blood pressure from the heart rate may produce a simple shock index that would be a clinically useful substitute for the shock index. In this study, we investigated whether the simple shock index was equivalent to the shock index.Methods: This observational cohort study was conducted at 2 tertiary care hospitals. Patients who were transported by ambulance were recruited for this study and were excluded if they were aged <15 years, had experienced prehospital cardiopulmonary arrest, or had undergone inter-hospital transfer. Pearson’s product-moment correlation coefficient and regression equation were calculated, and two one-sided tests were performed to examine their equivalency. Results: Among 5,429 eligible patients, the correlation coefficient between the shock index and simple shock index was extremely high (0.917, 95% confidence interval 0.912 to 0.921, P <.001). The regression equation was estimated as sSI = 258.55 log SI. The two one-sided tests revealed a very strong equivalency between the shock index and the index estimated by the above equation using the simple shock index (mean difference was 0.004, 90% confidence interval 0.003 to 0.005). Conclusion: The simple shock index strongly correlated with the shock index.

scholarly journals UK cardiac rehabilitation fit for purpose? A community-based observational cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037980
Author(s):  
Saïd Ibeggazene ◽  
Chelsea Moore ◽  
Costas Tsakirides ◽  
Michelle Swainson ◽  
Theocharis Ispoglou ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Heart Rate ◽  
Cohort Study ◽  
Arterial Stiffness ◽  
Observational Cohort Study ◽  
Habitual Physical Activity ◽  
Community Based ◽  
Observational Cohort ◽  
Exercise Dose

ObjectivesThis study aimed to characterise the exercise performed in UK cardiac rehabilitation (CR) and explore relationships between exercise dose and changes in physiological variables.DesignObservational cohort study.SettingOutpatient community-based CR in Leeds, UK. Rehabilitation sessions were provided twice per week for 6 weeks.ParticipantsSixty patients (45 male/15 female 33–86 years) were recruited following referral to local outpatient CR.Outcome measuresThe primary outcome was heart rate achieved during exercise sessions. Secondary outcomes were measured before and after CR and included incremental shuttle walk test (ISWT) distance and speed, blood pressure, brachial artery flow-mediated dilatation, carotid arterial stiffness and accelerometer-derived habitual physical activity behaviours.ResultsThe mean % of heart rate reserve patients exercised at was low and variable at the start of CR (42%±16 %) and did not progress by the middle (48%±17 %) or end (48%±16 %) of the programme. ISWT performance increased following CR (440±150 m vs 633±217 m, p<0.001); however, blood pressure, body weight, endothelial function, arterial stiffness and habitual physical activity behaviours were unchanged following 6 weeks of CR (p>0.05).ConclusionPatients in a UK CR cohort exercise at intensities that are variable but generally low. The exercise dose achieved using this CR format appears inadequate to impact markers of health. Attending CR had no effect on physical activity behaviours. Strategies to increase the dose of exercise patients achieve during CR and influence habitual physical activity behaviours may enhance the effectiveness of UK CR.

β-Blockers, Tachycardia, and Survival Following Sepsis: An Observational Cohort Study

2021 ◽  
Author(s):  
Dmitri Guz ◽  
Shira Buchritz ◽  
Alina Guz ◽  
Alon Ikan ◽  
Tania Babich ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cohort Study ◽  
Mortality Rate ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Internal Medicine Wards ◽  
Β Blockers

Abstract Background Sepsis is associated with excessive release of catecholamines, which causes tachycardia and is correlated with poor clinical outcome. β-Blockers (BBs) may blunt this effect on heart rate (HR). The objective of this study is to assess whether long-term BB therapy is associated with better clinical outcomes in patients with sepsis admitted to internal medicine wards. Methods We performed a single-center, observational cohort study. We included adult patients who were hospitalized in medicine departments due to sepsis. A propensity score model for BB therapy was used to match patients. The primary outcome was the 30-day all-cause mortality rate. A multivariate analysis was performed to identify risk factors for an adverse outcome. Patients were stratified according to absolute tachycardia (HR ≥100/min) or relative tachycardia at presentation (tachycardia index above the third quartile, with tachycardia index defined as the ratio of HR to temperature). Results A total of 1186 patients fulfilled the inclusion criteria. In the propensity-matched cohort patients given BB treatment were younger (median age [interquartile range], 74 [62–82] vs 81 [68–87] years; P ≤ .001). BB treatment was associated with reduction in 30-day mortality rates for patients with absolute tachycardia (odds ratio, 0.406; 95% confidence interval, .177–.932). Final model with interaction variable of BB treatment with HR was associated with short-term survival (odds ratio, 0.38; 95% confidence interval, .148–.976). Selective BB therapy had a stronger protective effect than nonselective BB therapy. Conclusions Long-term BB therapy was associated with decreased mortality rate in patients hospitalized with sepsis in internal medicine wards exhibiting absolute and relative tachycardia.

Diurnal blood pressure variation in adults after abdominal surgery–An observational cohort study

2022 ◽  
Vol 77 ◽  
pp. 110633
Author(s):  
Barak Cohen ◽  
Eva Rivas ◽  
Xuan Pu ◽  
Kamal Maheshwari ◽  
Jorge A. Araujo-Duran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Abdominal Surgery ◽  
Observational Cohort Study ◽  
Pressure Variation ◽  
Blood Pressure Variation ◽  
Observational Cohort

scholarly journals Shock Index as Simple Clinical Independent Predictor of In-hospital MACEs in NSTEMI Patients Presenting with Heart Failure

2017 ◽  
pp. 81-88
Author(s):  
Ahmad Handayani ◽  
Kartika Kaban ◽  
Marwan Nasri ◽  
Zulfikri Mukhtar ◽  
Abdullah Afif Siregar
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Independent Predictor ◽  
Shock Index ◽  
Laboratory Examination ◽  
Short Term ◽  
St Elevation ◽  
Grace Score

Background: Identification of Non-ST Elevation Myocardial Infarction (NSTEMI) patientsat higher risk of in-hospital complications is very important. Such identification will givecrucial information in determining treatment strategy especially for those come with heartfailure. One of the simple predictor for short term prognosis in acute coronary syndromeis shock index (SI), which is the ratio of heart rate over systolic blood pressure on admission.There had not been any study conducted to evaluate the use of SI in NSTEMI patientscome with heart failure. The aim of this study is to evaluate the SI compared with otherroutine clinical and laboratory examination as a predictor of in-hospital major adversecardiac events (MACEs) in NSTEMI patients presenting with heart failure.Methods: We performed a retrospective analysis of NSTEMI patients with heart failureadmitted to Haji Adam Malik General Hospital in Medan from January 2014 until July 2015.SI was calculated as the ratio of heart rate over systolic blood pressure on presentation.Patients presenting with cardiogenic shock were excluded.Results: There were 55 patients eligible in this study. In-hospital MACEs was found in 24patients (44%) compared with 31 patients (56%) without in-hospital MACEs. Patientswith in-hospital MACEs were older (60.6±10.8 vs. 57.2±7.9, p=0.178), had less historyof dyslipidemia [8(33%) vs. 19 (61%), p=0.032], faster heart rate (111.4±35.8 vs.96.5±24.3, p=0.032], higher GRACE score [139(98-187) vs. 120 (91-148); p=0.001],and higher SI [0.83(0.57-1.5) vs. 0.67 (0.38-1.27), p=0.013). SI >0.8 was the only independentpredictor of MACEs in NSTEMI patients presenting with heart failure (OR=4.3,CI=1.247-14.328, p=0.048).Conclusion: Beyond other routine examinations, SI is the only independent predictor ofin-hospital MACEs in NSTEMI patients presenting with heart failure.

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