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Reverse shock index multiplied by Glasgow Coma Scale score (rSIG) is a simple measure with high discriminant ability for mortality risk in trauma patients: an analysis of the Japan Trauma Data Bank.

Abstract：

BACKGROUND:The shock index (SI), defined as heart rate (HR) divided by systolic blood pressure (SBP), is reported to be a more sensitive marker of shock than traditional vital signs alone. In previous literature, use of the reverse shock index (rSI), taken as SBP divided by HR, is recommended instead of SI for hospital triage. Among traumatized patients aged > 55 years, SI multiplied by age (SIA) might provide better prediction of early post-injury mortality. Separately, the Glasgow Coma Scale (GCS) score has been shown to be a very strong predictor. When considering these points together, rSI multiplied by GCS score (rSIG) or rSIG divided by age (rSIG/A) could provide even better prediction of in-hospital mortality. METHODS:This retrospective, multicenter study used data from 168,517 patients registered in the Japan Trauma Data Bank for the period 2006-2015. We calculated areas under receiver operating characteristic curves (AUROCs) to measure the discriminant ability by comparing those of SI (or rSI), SIA, rSIG, and rSIG/A for in-hospital mortality and for 24-h blood transfusion. RESULTS:The highest ROC AUC (AUROC), 0.901(0.894-0.908) for in-hospital mortality in younger patients (aged < 55 years), was seen for rSIG. In older patients (aged ≥ 55 years), the AUROC of rSIG/A, 0.845(0.840-0.850), was highest for in-hospital mortality. However, the difference between rSIG and rSIG/A was slight and did not seem to be clinically important. rSIG also had the highest AUROC of 0.745 (0.741-749) for 24-h blood transfusion. CONCLUSIONS:rSIG ((SBP/HR) × GCS score) is easy to calculate without the need for additional information, charts or equipment, and can be a more reliable triage tool for identifying risk levels in trauma patients.

journal_name

Crit Care

journal_title

Critical care (London, England)

authors

Kimura A,Tanaka N

doi

10.1186/s13054-018-2014-0

subject

Has Abstract

pub_date

2018-04-11 00:00:00

pages

issue

eissn

1364-8535

issn

1466-609X

pii

10.1186/s13054-018-2014-0

journal_volume

pub_type

杂志文章,多中心研究

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Reverse shock index multiplied by Glasgow Coma Scale score (rSIG) is a simple measure with high discriminant ability for mortality risk in trauma patients: an analysis of the Japan Trauma Data Bank.