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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
  • 8,322 View
  • 251 Download
  • 13 Citations
AbstractAbstract PDF
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  
  • Clinical predictors of unplanned reoperations in trauma patients with damage control surgeries for truncal injuries
    Michael Semanco, Jennifer Montero, Nancy Russell, Ashley Diaz, Andrew C. Gaugler
    Trauma.2025;[Epub]     CrossRef
  • Association of Age Shock Index with Mortality among Trauma Patients in the Emergency Department
    Areej Zehra, Inayat Ali Khan, Muhammad Khan, Shahid Pervez Shaikh, Padma Rathore, Ghazal Irfan
    Pakistan Journal of Health Sciences.2025; : 209.     CrossRef
  • Evaluation of the role of repeated inferior vena cava sonography in estimating first 24 h fluid requirement in resuscitation of major blunt trauma patients in emergency department Suez Canal University Hospital
    Rasha Mahmoud Ahmed, Bassant Sayed Moussa, Mohamed Amin Ali, Aml Ibrahiem Sayed Ahmed Abo El Sood, Gouda Mohamed El Labban
    BMC Emergency Medicine.2024;[Epub]     CrossRef
  • Prehospital Delta Shock Index Predicts Mortality and Need for Life Saving Interventions in Trauma Patients
    Philip W. Walker, James F. Luther, Stephen R. Wisniewski, Joshua B. Brown, Ernest E. Moore, Martin Schreiber, Bellal Joseph, Chad T. Wilson, Brian G. Harbrecht, Daniel G. Ostermayer, Bryan Cotton, Richard Miller, Mayur Patel, Christian Martin-Gill, Jason
    Prehospital Emergency Care.2024; : 1.     CrossRef
  • Association of Shock Index and Modified Shock Index with Mortality Rate in Emergency Department Trauma Patient
    Areej Zehra, Farah Ahmed, Yasmeen Fatima Zaidi, Umaima Khan, Rabia Rauf, Samina Mohyuddin
    Pakistan Journal of Health Sciences.2024; : 134.     CrossRef
  • Delta shock index predicts injury severity, interventions, and outcomes in trauma patients: A 10-year retrospective observational study
    Mohammad Asim, Ayman El-Menyar, Khalid Ahmed, Mushreq Al-Ani, Saji Mathradikkal, Abubaker Alaieb, Abdel Aziz Hammo, Ibrahim Taha, Ahmad Kloub, Hassan Al-Thani
    World Journal of Critical Care Medicine.2024;[Epub]     CrossRef
  • 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
  • Outcomes of Trauma Patients Present to the Emergency Department with a Shock Index of ≥1.0
    Sharfuddin Chowdhury, P. J. Parameaswari, Luke Leenen
    Journal of Emergencies, Trauma, and Shock.2022; 15(1): 17.     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.
  • 1,440 View
  • 4 Download
AbstractAbstract 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
J Trauma Inj : Journal of Trauma and Injury
© The Korean Society of Traumatology.
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