The association of delta shock index and mortality in children with shock

Abstract Background: Shock remains one leading cause of morbidity and mortality in hospitalized children. Delta shock index is a simple tool to assess and evaluate shock. Objective: To investigate whether delta shock index might be related to mortality in children with shock. Methods: Prospective cohort study. Setting: Emergency Room (ER) and Pediatric Intensive Care Unit (PICU) of Sanglah University Hospital, Bali from March 2015 to March 2016. Patients and participants: Children aged 1- month to 12-year-old that were diagnosed with shock during admission or during hospitalization. Subjects were divided into delta shock index (DSI)?0 group and DSI>0. Results: From March 2015 to March 2016 a total of 80 subjects were recruited. There were 40 cases with DSI?0 and 40 cases with DSI>0. Mortality was found in 28 (70%) patients with DSI?0 group. Chi-square analysis showed significant association between DSI and mortality (RR 1.9, 95%CI:1.2-2.9; p=0.004). Survival analysis showed median time survival was 5 days for the group with DSI?0 and 7 days for the group with DSI>0 (log-rank 0.03). Cox regression analysis showed that DSI?0 (RR 1.895, 95%CI:0.989-3.623; p=0.037) and age (RR 0.988, 95%CI:0.979-0.997; p=0.015) were risk factors for mortality in children with shock. Conclusion: DSI?0 was associated with mortality in children with shock.