Comparison of Shock Indexes, Lactate Level, and Base Deficit in Predicting Mortality in Community-Acquired Pneumonia: A Retrospective Analysis

OpenAlex İngilizce

Aim: Community-acquired pneumonia (CAP) can lead to higher rates of morbidity and mortality. Shock index (SI) parameter can be easily calculated in patients who present to the emergency department, and has been used to predict mortality in numerous diseases. This study aimed to compare shock indices with each other and with lactate level and base deficit for predicting mortality in CAP. Material and Methods: This was a retrospective cohort study. Patients’ vital signs at the time of presentation to the emergency department were collected and the shock indices were calculated. The predictive performance of SI, adjusted shock index (ASI), modified shock index (MSI), blood lactate level, and base deficit in predicting mortality and hospitalization in patients with CAP was compared. Results: Among the 195 included patients (mean age 67.2 years, 55.9% male), the 30-day mortality rate was 9.8%. Lactate, SI, ASI, and MSI were significantly higher in nonsurvivors (p < 0.05), whereas base deficit showed no association (p = 0.635). The AUC (95% CI) values for predicting 30-day mortality were as follows: lactate = 0.656 (0.492–0.820), SI = 0.697 (0.540–0.854), ASI = 0.720 (0.581–0.858), and MSI = 0.694 (0.535–0.853). Among these, ASI had the highest sensitivity (70.6%) and acceptable specificity (70.1%). Conclusion: SI, ASI, MSI, and lactate levels may assist physicians in estimating short-term outcomes in CAP, but should not be used as standalone tools for clinical decision-making. Further multicenter prospective studies are warranted to confirm their predictive performance.