{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:38:19Z","timestamp":1770896299203,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FEMH hospital","award":["FEMH-2025-C-042"],"award-info":[{"award-number":["FEMH-2025-C-042"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Older adults with ST-segment elevation myocardial infarction (STEMI) experience disproportionately high mortality despite advances in reperfusion therapy. The Shock Index (SI) and Age\u2013Shock Index (ASI) offer rapid hemodynamic assessment but do not address hypoxia. The Hypoxia\u2013Age\u2013Shock Index (HASI), which incorporates oxygen saturation (SpO2), may improve early mortality prediction in geriatric STEMI. Materials and Methods: This retrospective cohort study included adult STEMI patients receiving primary percutaneous coronary intervention (PCI) at a tertiary center from 2019 to 2023. A total of 711 patients were analyzed, including 254 aged \u226565 years. SI, ASI, and HASI were calculated using triage vital signs prior to intervention. The primary outcome was in-hospital mortality. Thirty-day mortality was analyzed as a pre-specified secondary endpoint using Kaplan\u2013Meier survival analysis and multivariable Cox regression. Discrimination was assessed using ROC curves with pairwise AUC comparison by DeLong\u2019s test. Results: Elderly patients showed higher creatinine and troponin T levels, lower hemoglobin, and elevated ASI and HASI values (all p &lt; 0.001). They had increased rates of cardiogenic shock (26.8% vs. 14.0%), major adverse events (26.0% vs. 10.1%), and in-hospital mortality (9.4% vs. 3.7%, p = 0.003). Age \u2265 65 years independently predicted 30-day mortality (adjusted HR 2.59, 95% CI 1.34\u20135.04). Among indices, HASI demonstrated the highest discriminative performance (AUC 0.703 in elderly; 0.743 in younger patients). Conclusions: In geriatric STEMI, HASI demonstrated numerically higher discriminative performance for in-hospital mortality compared with SI and ASI, supporting its use as a simple and rapid triage tool.<\/jats:p>","DOI":"10.3390\/medicina62020365","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:48:34Z","timestamp":1770889714000},"page":"365","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of the Hypoxia\u2013Age\u2013Shock Index at Triage to Predict Mortality in Geriatric STEMI Patients Undergoing Primary PCI"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3147-8133","authenticated-orcid":false,"given":"Man-Ju","family":"Ting","sequence":"first","affiliation":[{"name":"Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei 100, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan-Ju","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"San-Fang","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyh-Shyong","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chih-Jung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6478-4754","authenticated-orcid":false,"given":"Chien-Chieh","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan"},{"name":"Department of Biomedical Engineering, National Taiwan University, Taipei 100, Taiwan"},{"name":"Department of Emergency Medicine, Ten Chan General Hospital, Chung-Li, Taoyuan City 320, Taiwan"},{"name":"International Bachelor Program in Electrical and Communication Engineering, Yuan Ze University, Taoyuan City 320, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1056\/NEJMoa2300468","article-title":"Complete or culprit-only PCI in older patients with myocardial infarction","volume":"389","author":"Biscaglia","year":"2023","journal-title":"N. 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