Comparison of Modified Shock Index and Age Modified Shock Index in Predicting Mortality of Patients Admitted to the Intensive Care Unit
Keywords:
Shock Index, Age Factors, Intensive Care Units, Mortality PredictionAbstract
OBJECTIVE: To compare the prognostic accuracy of the Age-Modified Shock Index (AMSI) and the Modified Shock Index (MSI) in predicting in-hospital mortality among adult patients admitted to the intensive care unit.
METHODOLOGY: This analytical cross-sectional study was conducted in the ICU (Intensive Care Unit), Department of Internal Medicine, ISRA University Hospital from June to October 2025. One hundred and eighty-two patients were recruited. The admission vital signs were used to calculate heart rate/mean arterial pressure (HR/MEA) and AMSI (Age x MSI). The ROC curves were analyzed to calculate and compare the areas under each index's curve. All data were processed using SPSS version 26.0.
RESULTS: The overall mortality rate was 22.5%. Non-survivors had significantly higher MSI (1.36±0.25) and AMSI (94.5±29.1) values compared to survivors (1.05±0.26 and 61.2±22.5, respectively; p < 0.001). AMSI demonstrated superior discriminatory power with an AUC of 0.88 (95% CI: 0.82–0.93), significantly higher than the AUC (Area under the curve) for MSI (0.79, 95% CI: 0.72–0.86; p = 0.022). The optimal cut-off for mortality prediction was ?1.2 for MSI (sensitivity 78.0%, specificity 71.6%) and ?75 for AMSI (sensitivity 83.0%, specificity 80.1%).
CONCLUSION: The Age-Modified Shock Index (AMSI) demonstrated significantly greater predictive accuracy for in-hospital mortality than the MSI, supporting its potential as a simple, rapid, and effective bedside risk-stratification tool in the ICU.
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