@article {E.Abd ElmoniemP2443, author = {Alaa E.Abd Elmoniem and Lamia Shaban and Maha Elkholy and Khalid Kotb and Salah Abo Saif}, title = {Shock index as a prognostic value in risk stratification of patients with acute pulmonary embolism}, volume = {42}, number = {Suppl 57}, elocation-id = {P2443}, year = {2013}, publisher = {European Respiratory Society}, abstract = {Background: Patients with acute pulmonary embolism (PE) presenting with haemodynamic instability have the worst prognosis. The Shock Index (SI) is a sensitive indicator of left ventricular dysfunction. Objective: To assess the value of shock index and echocardiographic abnormalities as predictors of in-hospital complications and mortality in patients with acute pulmonary embolism.Patients\&methods: 81 patients who were diagnosed as acute pulmonary embolism were included in this study. Haemodynamic instability defined by shock index >=1 (HR/systolic blood pressure).Detailed Doppler echocardiography (within 72h of admission)done for all patients. Results: Heart rate, systolic blood pressure and shock index \>1 were significantly higher and more frequent in patients with in hospital mortality (P\<0.05 each). Patients with in- hospital mortality have statistically significant right ventricular hypokinesia, RV/LV end diastolic diameter \>1, right ventricular end diastolic diameter \>3, interventricular septal flattening, peak systolic PAP \>50 mmHg and E/A ratio \<1 (P\<0.001, P\<0.001, P\<0.05, P\<0.001, P\<0.05, P\<0.01 respectively). In multivariate logistic regression analysis, shock index (SI)\>1 independent of right ventricular hypokinesia, RV/LV\>1 and systolic PAP\>50mmHg was associated with significant in-hospital mortality P\<0.0001. Conclusion: we can conclude that in pulmonary embolism patients, Shock index \> 1 was associated with increased in-hospital mortality independently of other abnormal echocardiographic Doppler parameters and could be helpful in early diagnosis of patients with acute pulmonary embolism who are in need for meticulous observation.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/Suppl_57/P2443}, eprint = {https://erj.ersjournals.com/content/42/Suppl_57/P2443.full.pdf}, journal = {European Respiratory Journal} }