Application of the shock index to the prediction of need for hemostasis intervention

摘要: Abstract Introduction The traditional method to identify hemorrhage after trauma has been vital signs–based. More recent attempts have used mathematical prediction models, but these are limited by the need for additional data including a Focused Assessment with Sonography Trauma exam, or an arterial blood gas. Shock Index (SI) is relationship of heart rate divided systolic pressure; cutoff > 0.9 associated bleeding. Methods A total 4292 patients were identified in database over 11 year period. Inclusion criteria included age > 16 years and initial presentation our center. Patients excluded incomplete data, traumatic brain injury, transfer leaving 4277 analysis. further subdivided age, mechanism injury (blunt versus penetrating). Finally, into bleeding nonbleeding, SI formula was applied their hospital signs. Results Across dataset, using standard as threshold bleeding, sensitivity 54.5%, specificity 93.6%. In geriatric subanalysis, there no difference between groups, more specific older patients. There blunt penetrating. Lowering ≥ 0.8 increases 76.1%, 87.4%. Conclusion SI, at lowered ≥ 0.8, can be that will require intervention hemostasis.