Use of the reverse shock index for identifying high-risk patients in a five-level triage system

摘要: The ratio of systolic blood pressure (SBP) to heart rate (HR), called the reverse shock index (RSI), is used evaluate hemodynamic stability trauma patients. To minimize undertriage in emergency departments (EDs), we evaluated whether RSI < 1 (i.e., SBP lower than HR) could be as an additional variable identify patients at high risk for more severe injury within a level category five-level Taiwan Triage and Acuity Scales (TTAS) system. Data obtained from Trauma Registry System, including triage according TTAS system, were retrospectively reviewed admissions January 2009 through December 2013 Level I center. In our study, primary outcomes severity measured using different scoring systems, Glasgow coma scale (GCS), abbreviated scores, score (ISS), in-hospital mortality. secondary hospital intensive care unit (ICU) length stay (LOS). Of 10,814 patients, 348 (3.2 %) had RSI < 1, whereas 10,466 (96.8 %) RSI ≥ 1. Those with greater severity, higher incidence commonly associated injuries, GCS deterioration vital signs, procedures those Patients also worse ICU LOS, frequency admission, Although system provides good prioritization major trauma, criterion same (I–III). alert patient’s being his/her HR (RSI < 1) without requirement any equipment makes concept RSI particularly valuable crowded EDs identifying high-risk 1 may serve principle trigger action ED surgeons need early intervention timely preparation upon patient arrival triaged levels II III alarming sign outcome. Within III, inclusion help serious injuries who upgraded management level.