Shock Index, Modified Shock Index, and Age-Adjusted Shock Index in Predicting the In-Hospital Mortality in Patients with Heart Failure and Chronic Kidney Disease

Patients with heart failure (HF) often have a poor prognosis, with high morbidity and mortality. In the Chinese adult population, the prevalence of HF increased by 44％ in the past 15 years, which was 1.3％[1]. HF is often associated with multiple organ disorders[2]. Renal insufficiency is common in patients with HF, and patients with chronic kidney disease (CKD) are significantly more likely to develop HF than patients without CKD. The incidence of HF with CKD ranged from 17％ to 21％, with HF being the main cause of mortality and morbidity in patients with CKD. More importantly, in patients with cardiac and renal dysfunction, the presence of one condition tends to worsen the presentation and progression of the other[3]. Patients with HF and CKD associate with remarkably increasing risk of hospitalization, re-hospitalization, kidney replacement therapy, and death, but most patients with renal insufficiency were excluded from HF related studies[3]. Therefore, it is particularly important to identify such high-risk patients.