• Mehdi Torabi, Shahrzad Moeinaddini, Amirhossein Mirafzal, Azam Rastegari, and Neda Sadeghkhani.
• Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran; Clinical Research Center, Afzalipoor Hospital, Kerman, Iran.
• Am J Emerg Med. 2016 Nov 1; 34 (11): 2079-2083.

ObjectivesTo elucidate the predictive capability of shock index (SI), modified SI (MSI), and age SI for mortality in patients assigned to Emergency Severity Index (ESI) level 3 patients.MethodsThis was a retrospective medical record review performed in an academic internal medicine emergency department in Kerman, Iran. All patients older than 14 years triaged to ESI level 3 were enrolled in the study. Triage time vital signs were used to calculate SI, MSI, and age SI. The primary outcome was in-hospital mortality.ResultsA total number of 3375 patients were enrolled in the study, in which 84 (2.5%) died during hospital stay. In the adjusted multivariate analysis, age SI, systolic blood pressure (SBP), and sex were independently associated with mortality, with P values (odds ratio [95% confidence interval]) of <.001 (1.03 [1.01-1.04]), .003 (0.97 [0.96-0.99]), and .04 (1.61 [1.01-2.59]), respectively. Receiver operating characteristic curve showed an area under curve of 0.717 for the 3-variable final model and an area under curve of 0.678 for age SI in mortality prediction.ConclusionsIn ESI level 3 patients, age SI and SBP showed to be better than SI or MSI in predicting mortality. However, because their predictive capability was modest, age SI or SBP should be considered adjuncts to sort actions in favor of patients with higher risk for mortality.Copyright © 2016 Elsevier Inc. All rights reserved.

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