Mortality prediction using the Shock Index and Modified Shock Index in the Emergency Department.

OBJECTIVES: to compare the Shock Index and the Modified Shock Index in predicting in-hospital mortality among patients diagnosed with shock and admitted to the Emergency Department. METHODS: a retrospective cohort (2022), including patients ≥18 years. The predictive ability was estimated using areas under the curve, sensitivity, and specificity, considering shock etiologies. RESULTS: 365 patients were included, (25.5 cases per 1,000 visits), mortality (75.3%), with a worse initial hemodynamic profile. Septic shock (69%) and hypovolemic shock (13.2%) predominated. The Shock Index demonstrated better areas under de curve in mixed (0.706) and septic (0.700) shock. The Modified Shock Index showed superiority in mixed (0.735), septic (0.700), and cardiogenic (0.700) shock, standing out in septic shock (sensitivity 96.0%; specificity 86.3%). CONCLUSIONS: the Modified Shock Index demonstrated greater predictive ability for mortality, suggesting its usefulness in nursing clinical practice.