New Vitals After Injury: Shock Index for the Young and Age Shock Index for the Old

摘要: Background The traditional view that tachycardia and hypotension accompany hemorrhagic shock following injury has been challenged. This is particularly true at extremes of age. Shock index (SI) may be an alternative indicator life-threatening bleeding after injury. Because age negatively impacts physiological reserve, we hypothesized multiplied by SI (Age × SI) would a better predictor 48 h mortality (48 MORT) compared to heart rate (HR), systolic blood pressure (SBP), or SI. Methods A Level I trauma center registry was used identify victims blunt injury, aged 18-84 (YOUNG ≤55 OLD >55) admitted from 1996-2005. Patients with head spinal cord injuries were excluded. The main outcome MORT. Areas under the receiver operating characteristic curves (AUC) for each determined. Results Sixteen thousand seventy-seven patients identified. Forty-eight MORT 1.27% (0.93% in YOUNG 3.17% OLD; P < 0.0001). Overall, (AUC 0.812) Age 0.831) predictors HR 0.716, 0.0001) SBP 0.753, = 0.0004) alone. In patients, AGE 0.828) 0.659 0.0001), 0.762 0.003), 0.787 0.0005). Conclusion SI are injured than should risk early