Association of Shock Index and Modified Shock Index with Mortality Rate in Emergency Department Trauma Patient

Shock Index and Mortality

Authors

  • Areej Zehra Department of Accident and Emergency, Imam Clinic, Karachi, Pakistan
  • Farah Ahmed Department of Community Health Science, Ziauddin University, Karachi, Pakistan
  • Yasmeen Fatima Zaidi Department of Community Medicine, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan
  • Umaima Khan Department of Accident and Emergency, Usman Memorial Hospital, Karachi, Pakistan
  • Rabia Rauf Department of Anatomy, Niazi Medical and Dental College, Sargodha, Pakistan
  • Samina Mohyuddin Department of Physiology, Liaquat College of Medicine and Dentistry, Karachi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i09.1835

Keywords:

Trauma Mortality, Modified Shock Index, Trauma Severity Markers, Hemodynamic Instability

Abstract

At the emergency room, triage was used to determine which patients were more seriously injured and in need of urgent care. Trauma remains one of the primary causes of morbidity and death even with the use of modern triage techniques. Objective: To find out the relationship between trauma patients' 48-hour mortality and the shock index and modified shock index at Emergency Departments (EDs). Methods: A study was conducted in the Emergency Ward of Ziauddin University Hospital, focusing on patients aged 18-65 who sustained trauma. The study involved 50 trauma patients admitted to a Level I trauma center. Data were collected on heart rate, blood pressure, and shock indices at the time of admission. A shock index cut-off value of 0.9 was used to determine its association with patient outcomes. Data collection involved patients visiting the emergency department, with informed consent obtained. SPSS version 21.0 was used for analysis. Results: The study involved 50 patients, with 25 in each exposed and unexposed group. Exposed patients had a higher average age, higher heart rates, and lower blood pressure. Road traffic accidents were the leading trauma mechanism in both groups. Open wounds were more common in exposed patients. Most exposed patients received intravenous fluids and inotropic support. Patients with a Shock Index ≥ 1 and a Modified Shock Index ≥ 1.3 had higher mortality rates. Conclusion: The study revealed a significant link between medical mortality in older adults and bruises in emergency departments, indicating that SI and Modified SI were effective markers for severity assessment.

References

Goddard SD, Jarman MP, Hashmi ZG. Societal burden of trauma and disparities in trauma care. Surgical Clinics. 2024 Apr; 104(2): 255-66. doi: 10.1016/j.suc.2023.09.009. DOI: https://doi.org/10.1016/j.suc.2023.09.009

Watts HF, Kerem Y, Kulstad EB. Evaluation of the revised trauma and injury severity scores in elderly trauma patients. Journal of emergencies, trauma, and shock. 2012 Apr; 5(2): 131-4. doi: 10.4103/0974-2700.96481. DOI: https://doi.org/10.4103/0974-2700.96481

Abhishek S, Trichur RV, Cattamanchi S, Vijayan P. Shock Index VS Modified Shock Index as a Predictor of Mortality among the COVID-19 Patients. 2024 Jan. doi: 10.20944/preprints202401.1519.v1. DOI: https://doi.org/10.20944/preprints202401.1519.v1

Liu YC, Liu JH, Fang ZA, Shan GL, Xu J, Qi ZW et al. Modified shock index and mortality rate of emergency patients. World Journal of Emergency Medicine. 2012; 3(2): 114. doi: 10.5847/wjem.j.issn.1920-8642.2012.02.006. DOI: https://doi.org/10.5847/wjem.j.issn.1920-8642.2012.02.006

Kim MJ, Park JY, Kim MK, Lee JG. Usefulness of shock index to predict outcomes of trauma patient: a retrospective cohort study. Journal of Trauma and Injury. 2019 Mar; 32(1): 17-25. doi: 10.20408/jti.2018.034. DOI: https://doi.org/10.20408/jti.2018.034

Yoon SH, Shin SJ, Kim H, Roh YH. Shock index and shock index, pediatric age-adjusted as predictors of mortality in pediatric patients with trauma: A systematic review and meta-analysis. PLOS One. 2024 Jul; 19(7): e0307367. doi: 10.1371/journal.pone.0307367. DOI: https://doi.org/10.1371/journal.pone.0307367

Al JN, Hamade B, Balhara KS, Hsieh YH, Bayram JD. Shock index as a predictor of hospital admission and inpatient mortality in a united states national database of emergency departments. Journal of Emergency Medicine. 2017 Sep; 53(3): 433. doi: 10.1016/j.jemermed.2017.08.040. DOI: https://doi.org/10.1016/j.jemermed.2017.08.040

Al Jalbout N, Balhara KS, Hamade B, Hsieh YH, Kelen GD, Bayram JD. Shock index as a predictor of hospital admission and inpatient mortality in a US national database of emergency departments. Emergency Medicine Journal. 2019 May; 36(5): 293-7. doi: 10.1136/emermed-2018-208002. DOI: https://doi.org/10.1136/emermed-2018-208002

Singh A, Ali S, Agarwal A, Srivastava RN. Correlation of shock index and modified shock index with the outcome of adult trauma patients: a prospective study of 9860 patients. North American Journal of Medical Sciences. 2014 Sep; 6(9): 450. doi: 10.4103/1947-2714.141632. DOI: https://doi.org/10.4103/1947-2714.141632

Montoya KF, Charry JD, Calle-Toro JS, Núñez LR, Poveda G. Shock index as a mortality predictor in patients with acute polytrauma. Journal of Acute Disease. 2015 Aug; 4(3): 202-4. doi: 10.1016/j.joad.2015.04.006. DOI: https://doi.org/10.1016/j.joad.2015.04.006

Bondariyan N, Vakhshoori M, Sadeghpour N, Shafie D. Prognostic value of shock index, modified shock index, and age-adjusted derivatives in prediction of in-hospital mortality in patients with acute decompensated heart failure: persian registry of cardiovascular disease/heart failure study. Anatolian Journal of Cardiology. 2022 Mar; 26(3): 210. doi: 10.5152/AnatolJCardiol.2021.671. DOI: https://doi.org/10.5152/AnatolJCardiol.2021.671

Milton M, Engelbrecht A, Geyser M. Predicting mortality in trauma patients-A retrospective comparison of the performance of six scoring systems applied to polytrauma patients from the emergency centre of a South African central hospital. African Journal of Emergency Medicine. 2021 Dec; 11(4): 453-8. doi: 10.1016/j.afjem.2021.09.001. DOI: https://doi.org/10.1016/j.afjem.2021.09.001

Torabi M, Moeinaddini S, Mirafzal A, Rastegari A, Sadeghkhani N. Shock index, modified shock index, and age shock index for prediction of mortality in Emergency Severity Index level 3. The American Journal of Emergency Medicine. 2016 Nov; 34(11): 2079-83. doi: 10.1016/j.ajem.2016.07.017. DOI: https://doi.org/10.1016/j.ajem.2016.07.017

Kim SY, Hong KJ, Do Shin S, Ro YS, Ahn KO, Kim YJ et al. Validation of the shock index, modified shock index, and age shock index for predicting mortality of geriatric trauma patients in emergency departments. Journal of Korean Medical Science. 2016 Dec; 31(12): 2026-32. doi: 10.3346/jkms.2016.31.12.2026. DOI: https://doi.org/10.3346/jkms.2016.31.12.2026

Carsetti A, Antolini R, Casarotta E, Damiani E, Gasparri F, Marini B et al. Shock index as predictor of massive transfusion and mortality in patients with trauma: a systematic review and meta-analysis. Critical Care. 2023 Mar 5; 27(1): 85. doi: 10.1186/s13054-023-04386-w. DOI: https://doi.org/10.1186/s13054-023-04386-w

Aleka P. The value of shock index, modified shock index and age shock index to predict critical outcomes in a district level emergency centre. 2023 Dec 13(4); 287-292. doi: 10.1016/j.afjem.2023.09.007. DOI: https://doi.org/10.1016/j.afjem.2023.09.007

Liao TK, Ho CH, Lin YJ, Cheng LC, Huang HY. Shock index to predict outcomes in patients with trauma following traffic collisions: a retrospective cohort study. European Journal of Trauma and Emergency Surgery. 2024 May: 1-8. doi: 10.1007/s00068-024-02545-4. DOI: https://doi.org/10.1007/s00068-024-02545-4

Günlü S, Kayan F, Karahan MZ. The predictive effect of shock index on mortality in patients with acute heart failure. Journal of Xiangya Medicine. 2023 Nov; 8. doi: 10.21037/jxym-23-20. DOI: https://doi.org/10.21037/jxym-23-20

Mutschler M, Nienaber U, Münzberg M, Wölfl C, Schoechl H, Paffrath T et al. The Shock Index revisited-a fast guide to transfusion requirement? A retrospective analysis on 21,853 patients derived from the TraumaRegister DGU®. Critical Care. 2013 Aug; 17: 1-9. doi: 10.1186/cc12851. DOI: https://doi.org/10.1186/cc12851

Sahu N, Yee S, Das M, Trinh S, Amoruso R, Connolly M et al. Shock index as a marker for mortality rates in those admitted to the medical intensive care unit from the emergency department. Cureus. 2020 Apr; 12(4). doi: 10.7759/cureus.7903. DOI: https://doi.org/10.7759/cureus.7903

Payza U, Karakaya Z, Topal FE, Akyol PY, Tahtaci R, Kayali A et al. Clinical benefits of shock index and modified shock index in pulmonary embolism for 30-day mortality prognosis. 2019 Sep; 26(9). DOI: https://doi.org/10.5455/annalsmedres.2019.06.329

Downloads

Published

2024-09-30
CITATION
DOI: 10.54393/pjhs.v5i09.1835
Published: 2024-09-30

How to Cite

Zehra, A., Ahmed, F., Zaidi, Y. F., Khan, U., Rauf, R., & Mohyuddin, S. (2024). Association of Shock Index and Modified Shock Index with Mortality Rate in Emergency Department Trauma Patient: Shock Index and Mortality. Pakistan Journal of Health Sciences, 5(09), 134–138. https://doi.org/10.54393/pjhs.v5i09.1835

Issue

Section

Original Article

Plaudit