Vol. 84, March 2016

Accuracy of Shock Index as A Predictor Tool for Differentiating Major from Minor Injuries in Adult Trauma Patients Attending to Emergency Department at Suez Canal University Hospital,

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Accuracy of Shock Index as A Predictor Tool for Differentiating Major from Minor Injuries in Adult Trauma Patients Attending to Emergency Department at Suez Canal University Hospital, NASHWA M. ABD EL-GELEEL, ADEL H. EL-BEIH, KHALED M. MORSY and GOUDA M. EL-LABBAN

 

Abstract
Background: The importance of early recognition of hemorrhagic shock and its effects on outcome have long been recognized. Traditional vital signs are relatively insensitive as early diagnostic markers of hemorrhage. The Shock Index (SI); Heart Rate (HR) divided by Systolic Blood Pressure (SBP), has been suggested as such a marker. We tested the accuracy of the SI in differentiating major from minor injury in trauma patients.
Aim: To assess accuracy of shock index as a simple and early predictor marker in differentiating major from minor injuries in trauma patients in Emergency Department at Suez Canal University Hospital.
Patients and Methods: This cross sectional study was conducted on 106 trauma patients, both genders and all age groups above 18 years old, admitted to Emergency Department at Suez Canal University Hospital. Demographics, injury mechanism, HR, SBP, base deficit and lactate were recorded and Injury Severity Score were calculated. Major injury was defined as either death within 24 hours, Injury Severity Score (ISS) <=16, Intensive Care Unit (ICU) stay <=1 day or amount of Blood Transfused (BT) <=2 units.
Results: One hundred and six trauma patients were en-rolled. There was 54.72% of patients has minor trauma and 45.28% of patients has major trauma. The area under the receiver operator characteristic curves for SI [0.98 95% Confidence Interval (CI) 0.92-0.99] was significantly more than that for base deficit (0.91, 95% CI: 0.84-0.95) or lactate (0.94, 95% CI: 0.87-0.97). Shock index was found to have higher sensitivity (95.83%) and specificity (96.55%) compared to either heart rate or systolic blood pressure alone.
Conclusion: The current study has shown that shock index is the most accurate parameter (with highest sensitivity and specificity) in differentiating major from minor trauma patients compared to base deficit and serum lactate. So, shock index can be conducted as a simple and early sensitive and specific predictor marker in differentiating major from minor injuries in trauma patients.

 

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