Shock index as a marker for significant injury in trauma patients

摘要: Objective: To determine whether the shock index (SI), defined as ratio of heart rate (HR) to systolic blood pressure (SBP), is a useful marker for significant injury in trauma patients. Methods: A retrospective database analysis was used relate SI clinical measures: death within 24 hours, severity score (ISS) ≥16, intensive care unit (ICU) stay ≥1 day, and amount transfused (BT) ≥2 units. Consecutive patients seen at one level I center over 24-month period were reviewed; excluded not requiring team consultation, or those with either incomplete records, severe head (Glasgow Coma Scale ≥8), age 14 years. The calculated from ED admission vital signs. Receiver operating characteristic (ROC) curves find value that maximized sum sensitivity specificity predicting each measure, separately; separate done optimal threshold any measures. Results: 1,101 cases met study criteria. values (by ROC analysis) measures were: 1.10 <24 0.71 ISS 0.77 ICU 0.85 BT above 0.83; use this cutoff provided 37% (95% CI 32–42%), 83% 80–87%). negative predictive 58% 54–61%) measure. This predicted between 24% fewer 4% more poor outcome than did thresholds HR SBP, respectively. Conclusion: performed similarly SBP prediction severity.