EBMcalc Medical Calculator

COVID-19 Severity by Shock Index and Modified Shock Index

Input

Heart Rate

Systolic BP

Diastolic BP

Results

Important: Inputs must be complete to perform calculation.

MAP

Shock Index

mShock Index

Decimal Precision

Data action

Include literature references: Yes No

Notes

This calculator represents findings from the literature referenced below. It is important to understand that these findings may not be representative of the experience in your local healthcare system.
In the Kurt article^[1] the Shock Index cutoff for hospital mortality was 0.72 with sensitivity of 71.2%, specificity of 69.6%, and ROC-AUC of 0.719. The mShock Index cutoff for hospital mortality was 1 with sensitivity of 74%, specificity of 72.4%, and a slightly better ROC-AUC of 0.739.
BP: blood pressure; MAP: mean arterial pressure.

Equations used

MAP = ((2 * Diastolic BP) + Systolic BP) / 3

Shock Index = Heart Rate / Systolic BP

mShock Index = Heart Rate / MAP

References

Kurt E, Bahadirli S. The Usefulness of Shock Index and Modified Shock Index in Predicting the Outcome of COVID-19 Patients. Disaster Med Public Health Prep. 2021 Jun 8:1-6. PubMed ID: 34099089
Liu YC, Liu JH, Fang ZA, et al. Modified shock index and mortality rate of emergency patients. World J Emerg Med. 2012;3(2):114-7. PubMed ID: 25215048
Ak R, Doganay F. Comparison of four different threshold values of shock index in predicting mortality of COVID-19 patients. Disaster Med Public Health Prep. 2021 Dec 23:1-15. PubMed ID: 34937595

Associated Medical Subject Headings [MeSH]

Adult, COVID-19, Emergency Service, Female, Heart Rate, Hospital, Hospital Mortality, Humans, Hypertension, Intensive Care Units, Male, Middle Aged, ROC Curve, Retrospective Studies, Severity of Illness Index, Shock, Triage

Associated Logical Observation Identifiers Names and Codes [LOINC]

Parameter	LOINC's and Suggested Units
Heart Rate	8867-4 : beats/min 8893-0 : beats/min 8890-6 : beats/min 8889-8 : beats/min 68999-2 : beats/min 76282-3 : beats/min 69000-8 : beats/min 69001-6 : beats/min
Systolic BP	8480-6 : mmHg
Diastolic BP	8462-4 : mmHg
MAP	8478-0 : mmHg 8458-2 : mmHg 76214-6 : mmHg 75996-9 : mmHg 76536-2 : mmHg
Shock Index	98909-5 : score
mShock Index	98910-3 : score

This material contains content from LOINC (http://loinc.org). LOINC is copyright © 1995-2023, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license at http://loinc.org/license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.

Associated HCC ICD10-CM codes

B97.29

Other coronavirus as the cause of diseases classified elsewhere

D68.69

Other Thrombophilia (COVID-19 associated hypercoagulability)

D68.8

Other Specified Coagulation Defects (COVID-19 associated coagulopathy)

J12.82

Pneumonia due to coronavirus disease

M35.81

Multisystem inflammatory syndrome.

M35.89

Other specified systemic involvement of connective tissue

COVID-19

Cardiogenic shock

Hypovolemic shock

Other shock

Severe sepsis with septic shock

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