SynthesisPloS one2015
Nontraumatic hypotension and shock in the emergency department and the prehospital setting, prevalence, etiology, and mortality: a systematic review.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed.
- Incidence of mortality and predictors among patients with shock managed in the emergency room of a tertiary hospital in Ethiopia.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- Prehospital invasive vs. non-invasive blood pressure monitoring: Impact on shock index at hospital admission in critically ill patients - a prospective intervention study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Observational
- Early initiated noradrenaline versus fluid therapy for hypotension and shock in the emergency department (VASOSHOCK): a protocol for a pragmatic, multi-center, superiority, randomized controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Accuracy of early shock recognition by paramedics: a multicenter prospective observational study in Japan.Journal of rural medicine : JRM · 2025Article
- Current Emergency Medical Service Vasoactive Use for the Management of Shock.Critical care explorations · 2024Article
- Prehospital factors predicting mortality in patients with shock: state-wide linkage study.Open heart · 2024Article
- Point of Care Ultrasonographic Life Support in Emergency (PULSE)-a quasi-experimental study.International journal of emergency medicine · 2023Article
- Article
- Review
- Incidence and Outcomes of Nontraumatic Shock in Adults Using Emergency Medical Services in Victoria, Australia.JAMA network open · 2022Article
- A Machine Learning Model for Early Prediction and Detection of Sepsis in Intensive Care Unit Patients.Journal of healthcare engineering · 2022Article
- Push-Dose Pressors During Peri-intubation Hypotension in the Emergency Department: A Case Series.Clinical practice and cases in emergency medicine · 2021Article
- Article
- Variation in central venous oxygen saturation to assess volume responsiveness in hemodynamically unstable patients under mechanical ventilation: a prospective cohort study.Critical care (London, England) · 2021Article
- Article
- Article
- Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2).Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Observational
- Clinical characteristics and course of out-of-hospital shock in a national emergency medical services cohort.Journal of the American College of Emergency Physicians open · 2020Article
- Reliability of Emergency Department Diagnosis in Identifying the Etiology of Nontraumatic Undifferentiated Hypotension.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2020Article
Corrections and comments
- Commented on by
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute patients presenting with hypotension in the prehospital or emergency department (ED) setting are in need of focused management and knowledge of the epidemiology characteristics might help the clinician. The aim of this review was to address prevalence, etiology and mortality of nontraumatic hypotension (SBP ≤ 90 mmHg) with or without the presence of shock in the prehospital and ED setting.
methodsWe performed a systematic literature search up to August 2013, using Medline, Embase, Cinahl, Dare and The Cochrane Library. The analysis and eligibility criteria were documented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-guidelines) and The Cochrane Collaboration. No restrictions on language, publication date, or status were imposed. We used the Newcastle-Ottawa quality assessment scale (NOS-scale) and the Strengthening the Reporting of Observational studies in Epidemiology (STROBE-statement) to assess the quality.
resultsSix observational studies were considered eligible for analysis based on the evaluation of 11,880 identified papers. Prehospital prevalence of hypotension was 19.5/1000 emergency medicine service (EMS) contacts, and the prevalence of hypotensive shock was 9.5-19/1000 EMS contacts with an inhospital mortality of shock between 33 to 52%. ED prevalence of hypotension was 4-13/1000 contacts with a mortality of 12%. Information on mortality, prevalence and etiology of shock in the ED was limited. A meta-analysis was not feasible due to substantial heterogeneity between studies.
conclusionThere is inadequate evidence to establish concise estimates of the characteristics of nontraumatic hypotension and shock in the ED or in the prehospital setting. The available studies suggest that 2% of EMS contacts present with nontraumatic hypotension while 1-2% present with shock. The inhospital mortality of prehospital shock is 33-52%. Prevalence of hypotension in the ED is 1% with an inhospital mortality of 12%. Prevalence, etiology and mortality of shock in the ED are not well described.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.