Society of University SurgeonsA prehospital shock index for trauma correlates with measures of hospital resource use and mortality
Section snippets
Methods
This study is a retrospective review of trauma registry data from a level I trauma center in Jacksonville, Florida, that serves both rural and urban areas. All trauma patients presenting between January 1, 2006 and December 31, 2010 were evaluated for inclusion. Excluded from the study were patients under 16 years of age, patients with incomplete data, and those not transported directly from the scene by emergency medical services. Data were collected for the 16,269 included patients using the
Results
The mean age of the 16,269 patients included in the study was 38.8 years (range, 16–100). The most common mechanisms of injury were motor vehicle crashes (44.9%), falls (11.2%), gunshot wounds (9.6%), motorcycle crashes (8.7%), pedestrians struck by vehicles (6.3%), and stab wounds (5.8%).
The mean prehospital SI was 0.64, and 3,200 patients had a prehospital SI of ≥0.9. In the trauma center, the mean SI upon arrival was 0.71, and 2,242 trauma center SIs were ≥0.9. These values were
Discussion
Trauma continues to be one of the leading causes of morbidity and mortality in the United States. The current statewide trauma alert guidelines in Florida use respiratory status, Glasgow Coma Scale, tachycardia, presence of long bone fractures, age, and mechanism of injury to guide triage decision-making. The combination of multiple vital signs is not currently used. Also, there are no specific criteria in place to evaluate a patient's need for expedited or possible air transport to a trauma
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Prehospital shock index predicts 24-h mortality in trauma patients with a normal shock index upon emergency department arrival
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2020, Journal of Surgical ResearchCitation Excerpt :Of these proposed scoring systems, shock index (SI), defined as heart rate divided by systolic blood pressure (SBP), continues to be one of the most studied tools. SI remains an attractive score because of its ease of calculation as well as its usefulness in predicting mortality, transfusion requirements, hospital and intensive care unit stay, and number of days on the ventilator.7-10 Multiple variations of the SI have recently emerged in an attempt to correct for varying cofactors such as age and traumatic brain injury, which may prove important for outcomes prediction.11-14