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Predictive Value of Shock Index and Age-Adjusted Shock Index for Hypotension after Tracheal Intubation in Critically Ill Patients

Zheng Huang^1,2, Zeng Wen MA^1,2, Shu Yun Xu^1,2*
1Department of Emergency, West China Hospital, Sichuan University, Chengdu 610041, China
²Department of Emergency, Shangjin Nanfu Hospital of West China, Sichuan University, Chengdu 611743, China

Corresponding Author: Shu Yun Xu
Address: Emergency Department, Sichuan University West China Hospital, No. 37, Guoxue Alley, Wuhou District, Chengdu, Sichuan Province, 610041 China.
Received date: 09 December 2024; Accepted date: 04 January 2025; Published date: 11 January 2025

Citation: Huang Z, Ma ZW, Xu SY. Predictive Value of Shock Index and Age-Adjusted Shock Index for Hypotension after Tracheal Intubation in Critically Ill Patients. Asp Biomed Clin Case Rep. 2025 Jan 11;8(1):44-50.

Copyright © 2025 Huang Z, Ma ZW, Xu SY. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords
Critically Ill Patients, Hypotension, Tracheal Intubation, Shock Index, Age-Adjusted Shock Index, Predictive Value

Abstract

Objective: To evaluate the predictive value of the Shock Index (SI) and Age-Adjusted Shock Index (AASI) for hypotension following tracheal intubation in critically ill patients, providing a theoretical basis for clinical decision-making.
Methods: Clinical data were retrospectively collected and analyzed for patients who underwent tracheal intubation in the Emergency Department of Chengdu Shangjin Nanfu Hospital from January 1, 2021, to December 31, 2022. Patients were divided into hypotension and non-hypotension groups based on post-intubation outcomes. Univariate analysis identified risk factors for post-intubation hypotension, and multivariate logistic regression determined the relationship between hypotension and these risk factors. Receiver Operating Characteristic (ROC) curves were used to determine the optimal thresholds for these risk factors.
Results: A total of 152 patients were included, with 35 experiencing hypotension after intubation. The hypotension group had significantly lower systolic blood pressure, diastolic blood pressure, oxygen saturation, hematocrit, hemoglobin, and albumin levels, while age, heart rate, SI (1.33±0.62 vs. 0.87±0.45), and AASI (83.23±49.62 vs. 50.72±30.01) were significantly higher (P < 0.05). Multivariate logistic regression revealed that systolic blood pressure, diastolic blood pressure, oxygen saturation, SI, and AASI were independent risk factors for post-intubation hypotension. ROC curve analysis showed that the area under the curve (AUC) for SI was 0.731 [95% CI (0.628, 0.835), P < 0.05], with a sensitivity of 62.9% and specificity of 78.6%. The AUC for AASI was 0.757 [95% CI (0.658, 0.856), P < 0.05], with a sensitivity of 65.7% and specificity of 79.5%.
Conclusion: SI and AASI have significant predictive value for hypotension following tracheal intubation in critically ill patients.