Journal of Trauma and Injury

Original Articles

Usefulness of Shock Index to Predict Outcomes of Trauma Patient: A Retrospective Cohort Study: Myoung Jun Kim, Jung Yun Park, Mi Kyoung Kim, Jae Gil Lee; J Trauma Inj. 2019;32(1):17-25. Published online March 31, 2019; DOI: https://doi.org/10.20408/jti.2018.034

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Purpose

We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma.

Methods

We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers.

Results

Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals “age” (p<0.001; OR, 1.068), “pre-hospital SI >0.9” (p<0.001; OR, 11.629), and “delta SI ≥0.3” (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression.

Conclusions

SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

Summary

Citations

Citations to this article as recorded by

Shock Index for the Prediction of Interventions and Mortality in Patients With Blunt Thoracic Trauma
Mohammad Asim, Ayman El-Menyar, Talat Chughtai, Ammar Al-Hassani, Husham Abdelrahman, Sandro Rizoli, Hassan Al-Thani
Journal of Surgical Research.2023; 283: 438. CrossRef
Emergency Department Shock Index Outperforms Prehospital and Delta Shock Indices in Predicting Outcomes of Trauma Patients
Hamidreza Hosseinpour, Tanya Anand, Sai Krishna Bhogadi, Christina Colosimo, Khaled El-Qawaqzeh, Audrey L. Spencer, Lourdes Castanon, Michael Ditillo, Louis J. Magnotti, Bellal Joseph
Journal of Surgical Research.2023; 291: 204. CrossRef
Shock index as a predictor for mortality in trauma patients: a systematic review and meta-analysis
Malene Vang, Maria Østberg, Jacob Steinmetz, Lars S. Rasmussen
European Journal of Trauma and Emergency Surgery.2022; 48(4): 2559. CrossRef
Delta Shock Index Predicts Outcomes in Pediatric Trauma Patients Regardless of Age
Samer Asmar, Muhammad Zeeshan, Muhammad Khurrum, Jorge Con, Mohamad Chehab, Letitia Bible, Rifat Latifi, Bellal Joseph
Journal of Surgical Research.2021; 259: 182. CrossRef
Shock index as a predictor for short‐term mortality in helicopter emergency medical services: A registry study
Johannes Björkman, Lasse Raatiniemi, Piritta Setälä, Jouni Nurmi
Acta Anaesthesiologica Scandinavica.2021; 65(6): 816. CrossRef
Association between prehospital field to emergency department delta shock index and in-hospital mortality in patients with torso and extremity trauma: A multinational, observational study
Dae Kon Kim, Joo Jeong, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Young Sun Ro, Tae Han Kim, Sabariah Faizah Jamaluddin, Zsolt J. Balogh
PLOS ONE.2021; 16(10): e0258811. CrossRef

The Clinical Usefulness of Halo Sign on CT Image of Trauma Patients: Seung Yong Lee, You Dong Sohn, Hee Cheol Ahn, Gu Hyun Kang, Jung Tae Choi, Moo Eob Ahn, Jeong Youl Seo; J Korean Soc Traumatol. 2007;20(2):144-148.

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Abstract PDF: PURPOSE
The management of hemorrhagic shock is critical for trauma patients. To assess hemorrhagic shock, the clinician commonly uses a change in positional blood pressure, the shock index, an estimate of the diameter of inferior vena cava based on sonography, and an evaluation of hypoperfusion complex shown on a CT scan. To add the finding for the hypoperfusion complex, the 'halo sign' was introduced recently. To our knowledge, this 'halo sign' has not been evaluated for its clinical usefulness, so we designed this study to evaluate its usefulness and to find the useful CT signs for hypoperfusion complex.
METHODS
The study was done from January 2007 to May 2007. All medical records and CT images of 124 patients with trauma were reviewed, of which 103 patients were included. Exclusion criteria was as follows: 1) age < 15 year old and 2) head trauma score of AIS > or = 5.
RESULTS
The value of kappa, to assess the inter-observer agreement, was 0.51 (p < 0.001). The variables of the halo-sign-positive group were statistically different from those of the halo-sign-negative group. The rate of transfusion for the halo-sign-positive group was about 10 times higher than that of the halo-sign-negative group and the rate of mortality was about 6 times higher.
CONCLUSION
In the setting of trauma, early abdominal CT can show diffuse abnormalities due to hypoperfusion complex. Recognition of these signs is important in order to prevent an unwanted outcome in hemorrhagic shock. We conclude that the halo sign is a useful one for hypoperfusion complex and that it is useful for assessing the degree of hemorrhagic shock.; Summary

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