Shock Index Predicts up to 90-day Mortality Risk after Intracerebral Haemorrhage

Tiberiu Pana; Terence J Quinn; Jesus Perdomo Lampignano; Weronika A. Szlachetka; Charles Knoery; Mamas A Mamas; Phyo K Myint; VISTA-ICH Collaborators

doi:10.1016/j.clineuro.2021.106994

Shock Index Predicts up to 90-day Mortality Risk after Intracerebral Haemorrhage

Tiberiu Pana, Terence J Quinn, Jesus Perdomo Lampignano, Weronika A. Szlachetka, Charles Knoery, Mamas A Mamas, Phyo K Myint^* (Corresponding Author), VISTA-ICH Collaborators

^*Corresponding author for this work

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Abstract

Background: Shock index (SI - heart rate/systolic blood pressure) has been studied as a measure of haemodynamic status. We aimed to determine whether SI measures within 72 hours of admission were associated with adverse outcomes in intracerebral haemorrhage (ICH).

Methods: Patients were drawn from the Virtual International Stroke Trials Archive6 Intracerebral Haemorrhage (VISTA-ICH). Multivariable Cox regressions modelled the relationship between SI (on admission, 24, 48, 72 hours) and mortality (at 3-, 7-, and 90-days), 90-day incident pneumonia and cardiovascular events (MACE). Ordinal logistic regressions modelled the relationship between SI and 90-day modified Rankin Scale (mRS).

Results: 979 patients were included. Baseline SI was not associated with mortality. 24h SI >0.7 was associated with 7-day mortality (hazard ratio (95% confidence interval) = 3.14 (1.37-7.19)). 48h and 72h SI >0.7 were associated with 7-day (4.23 (2.07-8.66) and 3.24 (1.41-7.42) respectively) and 90-day mortality (2.97 (1.82-4.85) and 2.05 (1.26-3.61) respectivley). SI <0.5 at baseline, 48h and 72h was associated with decreased pneumonia risk. 24h and 48h SI >0.7was associated with increased MACE risk. 48h and 72h SI >0.7 was associated with increased odds of higher 90-day mRS.

Conclusion: Higher-than-normal SI subsequent to initial encounter was associated with higher post-ICH mortality at 3, 7, and 90 days. Lower-than-normal SI was associated with a decreased risk of incident pneumonia.

Original language	English
Article number	106994
Number of pages	7
Journal	Clinical Neurology and Neurosurgery
Volume	210
Early online date	26 Oct 2021
DOIs	https://doi.org/10.1016/j.clineuro.2021.106994
Publication status	Published - 30 Nov 2021

Bibliographical note

ACKNOWLEDGEMENTS
The following individuals should be indexed on PubMed as collaborators - VISTA-ICH Steering Committee: DF Hanley (Chair), K Butcher, S Davis, B Gregson, KR Lees, P Lyden, S Mayer, K Muir, and T Steiner

Keywords

intracerebral haemorrhage
stroke
mortality
shock index
blood pressure

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Cite this

@article{46050945dcb441ac8738b5b74fa0fb61,

title = "Shock Index Predicts up to 90-day Mortality Risk after Intracerebral Haemorrhage",

abstract = "Background: Shock index (SI - heart rate/systolic blood pressure) has been studied as a measure of haemodynamic status. We aimed to determine whether SI measures within 72 hours of admission were associated with adverse outcomes in intracerebral haemorrhage (ICH).Methods: Patients were drawn from the Virtual International Stroke Trials Archive6 Intracerebral Haemorrhage (VISTA-ICH). Multivariable Cox regressions modelled the relationship between SI (on admission, 24, 48, 72 hours) and mortality (at 3-, 7-, and 90-days), 90-day incident pneumonia and cardiovascular events (MACE). Ordinal logistic regressions modelled the relationship between SI and 90-day modified Rankin Scale (mRS).Results: 979 patients were included. Baseline SI was not associated with mortality. 24h SI >0.7 was associated with 7-day mortality (hazard ratio (95% confidence interval) = 3.14 (1.37-7.19)). 48h and 72h SI >0.7 were associated with 7-day (4.23 (2.07-8.66) and 3.24 (1.41-7.42) respectively) and 90-day mortality (2.97 (1.82-4.85) and 2.05 (1.26-3.61) respectivley). SI <0.5 at baseline, 48h and 72h was associated with decreased pneumonia risk. 24h and 48h SI >0.7was associated with increased MACE risk. 48h and 72h SI >0.7 was associated with increased odds of higher 90-day mRS.Conclusion: Higher-than-normal SI subsequent to initial encounter was associated with higher post-ICH mortality at 3, 7, and 90 days. Lower-than-normal SI was associated with a decreased risk of incident pneumonia.",

keywords = "intracerebral haemorrhage, stroke, mortality, shock index, blood pressure",

author = "Tiberiu Pana and Quinn, {Terence J} and {Perdomo Lampignano}, Jesus and Szlachetka, {Weronika A.} and Charles Knoery and Mamas, {Mamas A} and Myint, {Phyo K} and {VISTA-ICH Collaborators}",

note = "ACKNOWLEDGEMENTS The following individuals should be indexed on PubMed as collaborators - VISTA-ICH Steering Committee: DF Hanley (Chair), K Butcher, S Davis, B Gregson, KR Lees, P Lyden, S Mayer, K Muir, and T Steiner",

year = "2021",

month = nov,

day = "30",

doi = "10.1016/j.clineuro.2021.106994",

language = "English",

volume = "210",

journal = "Clinical Neurology and Neurosurgery",

issn = "0303-8467",

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TY - JOUR

T1 - Shock Index Predicts up to 90-day Mortality Risk after Intracerebral Haemorrhage

AU - Pana, Tiberiu

AU - Quinn, Terence J

AU - Perdomo Lampignano, Jesus

AU - Szlachetka, Weronika A.

AU - Knoery, Charles

AU - Mamas, Mamas A

AU - Myint, Phyo K

AU - VISTA-ICH Collaborators

N1 - ACKNOWLEDGEMENTS The following individuals should be indexed on PubMed as collaborators - VISTA-ICH Steering Committee: DF Hanley (Chair), K Butcher, S Davis, B Gregson, KR Lees, P Lyden, S Mayer, K Muir, and T Steiner

PY - 2021/11/30

Y1 - 2021/11/30

N2 - Background: Shock index (SI - heart rate/systolic blood pressure) has been studied as a measure of haemodynamic status. We aimed to determine whether SI measures within 72 hours of admission were associated with adverse outcomes in intracerebral haemorrhage (ICH).Methods: Patients were drawn from the Virtual International Stroke Trials Archive6 Intracerebral Haemorrhage (VISTA-ICH). Multivariable Cox regressions modelled the relationship between SI (on admission, 24, 48, 72 hours) and mortality (at 3-, 7-, and 90-days), 90-day incident pneumonia and cardiovascular events (MACE). Ordinal logistic regressions modelled the relationship between SI and 90-day modified Rankin Scale (mRS).Results: 979 patients were included. Baseline SI was not associated with mortality. 24h SI >0.7 was associated with 7-day mortality (hazard ratio (95% confidence interval) = 3.14 (1.37-7.19)). 48h and 72h SI >0.7 were associated with 7-day (4.23 (2.07-8.66) and 3.24 (1.41-7.42) respectively) and 90-day mortality (2.97 (1.82-4.85) and 2.05 (1.26-3.61) respectivley). SI <0.5 at baseline, 48h and 72h was associated with decreased pneumonia risk. 24h and 48h SI >0.7was associated with increased MACE risk. 48h and 72h SI >0.7 was associated with increased odds of higher 90-day mRS.Conclusion: Higher-than-normal SI subsequent to initial encounter was associated with higher post-ICH mortality at 3, 7, and 90 days. Lower-than-normal SI was associated with a decreased risk of incident pneumonia.

AB - Background: Shock index (SI - heart rate/systolic blood pressure) has been studied as a measure of haemodynamic status. We aimed to determine whether SI measures within 72 hours of admission were associated with adverse outcomes in intracerebral haemorrhage (ICH).Methods: Patients were drawn from the Virtual International Stroke Trials Archive6 Intracerebral Haemorrhage (VISTA-ICH). Multivariable Cox regressions modelled the relationship between SI (on admission, 24, 48, 72 hours) and mortality (at 3-, 7-, and 90-days), 90-day incident pneumonia and cardiovascular events (MACE). Ordinal logistic regressions modelled the relationship between SI and 90-day modified Rankin Scale (mRS).Results: 979 patients were included. Baseline SI was not associated with mortality. 24h SI >0.7 was associated with 7-day mortality (hazard ratio (95% confidence interval) = 3.14 (1.37-7.19)). 48h and 72h SI >0.7 were associated with 7-day (4.23 (2.07-8.66) and 3.24 (1.41-7.42) respectively) and 90-day mortality (2.97 (1.82-4.85) and 2.05 (1.26-3.61) respectivley). SI <0.5 at baseline, 48h and 72h was associated with decreased pneumonia risk. 24h and 48h SI >0.7was associated with increased MACE risk. 48h and 72h SI >0.7 was associated with increased odds of higher 90-day mRS.Conclusion: Higher-than-normal SI subsequent to initial encounter was associated with higher post-ICH mortality at 3, 7, and 90 days. Lower-than-normal SI was associated with a decreased risk of incident pneumonia.

KW - intracerebral haemorrhage

KW - stroke

KW - mortality

KW - shock index

KW - blood pressure

U2 - 10.1016/j.clineuro.2021.106994

DO - 10.1016/j.clineuro.2021.106994

M3 - Article

C2 - 34781088

SN - 0303-8467

VL - 210

JO - Clinical Neurology and Neurosurgery

JF - Clinical Neurology and Neurosurgery

M1 - 106994

ER -

Shock Index Predicts up to 90-day Mortality Risk after Intracerebral Haemorrhage

Abstract

Bibliographical note

Keywords

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