Biomarkers, shock index and modified early warning score among older medical hospital inpatients in Nigeria

Figures & data

Table 1: Mean values of biomarkers by outcomes of hospitalisation on admission

Variables	Dead = 99 Mean ± SD	Discharged = 351 Mean ± SD	t-test value	p-value
Cardiovascular functioning (n = 450):
Temperature (°C)	36.9 ± 0.6	36.8 ± 0.5	0.664	0.509
Systolic blood pressure (mmHg)	141.5 ± 42.0	164.8 ± 44.2	−0.502	0.618
Diastolic blood pressure (mmHg)	81.8 ± 10.6	84.0 ± 10.9	−1.663	0.411
Respiratory rate (cycles/min)	27.6 ± 8.2	28.4 ± 11.8	−0.357	0.723
Pulse rate (beats/min)	93.3 ± 11.3	91.9 ± 10.1	1.181	0.242
SpO2 (%)	95.8 ± 3.6	95.9 ± 3.5	−0.339	0.741
Body measurements/indicators of obesity (n = 424):
Weight (kg)	72.3 ± 11.9	71.4 ± 10.8	0.629	0.530
Height (cm)	165.3 ± 7.5	163.4 ± 7.8	1.986	0.048*
Waist circumference (cm)	94.0 ± 16.3	94.9 ± 6.9	−0.442	0.659
Hip circumference (cm)	97.9 ± 11.8	99.0 ± 12.2	−0.717	0.474
Waist–hip ratio (WHR)	0.959 ± 0.1	0.962 ± 0.2	−0.126	0.900
Body mass index (kg/m^2)	26.6 ± 5.1	26.9 ± 5.1	−0.379	0.705
Metabolic processes (n = 389):
Total cholesterol (g/dl)	186.8 ± 48.6	178.4 ± 46.6	1.142	0.254
HDL (g/dl)	46.5 ± 16.2	50.1 ± 18.1	−1.410	0.160
LDL (g/dl)	106.2 ± 29.7	98.0 ± 27.2	1.831	0.068
LDL/HDL ratio	2.4 ± 0.8	2.2 ± 0.7	2.353	0.019*
TGA (g/dl)	119.1 ± 45.2	114.5 ± 36.3	0.687	0.493
Immune status and other haematological processes (n = 393):
WBC (/mm3)	16 377 ± 41 251	11 351 ± 7 923	1.020	0.308
PCV (%)	32.6 ± 7.8	33.9 ± 9.3	−1.161	0.249
Platelets (/litre)	248 366 ± 137 410	255 178 ± 147 442	−0.349	0.727

*Significant at 5% level of significance.

Table 2: Median survival times of hospitalisation by vital signs on admission

Variables	Number of respondents	Number of deaths n (%)	MST ± SE (days)	95% CI of MST (days)	Log rank (Mantel–Cox) chi-square	p-value
Temperature (°C):
< 39.0	436	93 (21.3)	36.0 ± 2.6	30.8–41.1	3.866	0.049*
≥ 39.0	14	6 (42.9)	17.0 ± 5.1	7.0–27.0
Pulse rate (beats per minute):
< 100	326	64 (19.6)	40.0 ± 3.5	33.2–46.8	4.493	0.034*
≥ 100	124	35 (28.2)	30.0 ± 4.2	21.7–38.6
Systolic blood pressure (mmHg):
< 120	118	32 (27.1)	29.0 ± 4.4	26.2–31.8	3.901	0.048*
≥ 120	332	67 (20.2)	40.0 ± 2.9	34.8–45.2
Diastolic blood pressure (mmHg):
< 60	56	14 (25.0)	36.0 ± 3.2	29.7–42.3	0.186	0.666
≥ 60	394	85 (21.6)	40.0 ± 4.2	31.8–48.2
Respiratory rate (cycles per minute)
≥ 25	242	59 (24.4)	36.0 ± 3.0	30.1–41.9	0.143	0.706
< 25	208	40 (19.2)	40.0 ± 6.4	27.4–52.6

*Significant at 5% level of significance.

Figure 1: (a) The survival function of hospitalisation by shock index; (b) The survival function of hospitalisation by age shock index (age SI); (c) The survival function of hospitalisation by modified shock index (MSI).

Table 3: Median survival times of hospitalisation by SI, MSI and age SI on admission

Variables	Number of respondents	Number of deaths n (%)	MST ± SE (days)	95% CI of MST (days)	Log rank (Mantel–Cox) chi-square	p-value
Shock index (SI):
< 1.0	419	88 (21.0)	40.0 ± 2.4	35.3–44.7	4.156	0.041*
≥ 1.0	31	11 (35.5)	30.0 ± 13.2	4.0–55.9
Age shock index (Age SI):
< 50	268	52 (19.4)	40.0 ± 4.5	31.6–48.8	4.753	0.029*
≥ 50	182	47 (25.8)	30.0 ± 3.3	23.6–36.4
Modified shock index (MSI):
< 1.3	438	94 (21.5)	36.0 ± 2.2	31.6–40.4	0.894	0.344
≥ 1.3	12	5 (41.7)	30.0 ± 14.6	13.8–58.6

*Significant at 5% level of significance.

Table 4: Multiple Cox regression model of all-cause mortality and biomarkers

Factor	Β	p-value	Hazard ratio (95% CI)
Temperature (≥ 39.0°C)	1.199	0.008*	3.317 (1.281–8.590)
Pulse rate (≥ 100 bpm)	0.385	0.151	1.469 (0.865–2.496)
Systolic blood pressure (< 120 mmHg)	0.612	0.042*	1.845 (1.025–3.322)
Shock index (≥ 1.0)	0.357	0.434	1.429 (0.589–3.472)
Age SI (≥ 50)	0.245	0.379	1.278 (0.740–2.208)

*Significant at 5% level of significance.