ArticlePloS one2019
Shock index increase from the field to the emergency room is associated with higher odds of massive transfusion in trauma patients with stable blood pressure: A cross-sectional analysis.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Risk factors for blood transfusion in traumatic and postpartum hemorrhage patients: Analysis of the CRASH-2 and WOMAN trials.PloS one · 2020Trial
- Standardized synchronization and validation pipeline for physiological biomarkers across multiple devices.Behavior research methods · 2026Article
- Shock Index versus Systolic Blood Pressure for Mortality Prediction in Traumatic Hemorrhage: A Comparative Prognostic Evaluation in a Middle-Income Country.Open access emergency medicine : OAEM · 2026Article
- Narrowed pulse pressure as a predictor of active hemorrhage in hemodynamically stable blunt trauma: Insights from an Asian cohort.Pakistan journal of medical sciences · 2025Article
- Evaluation of the delta shock index as an indicator of outcomes in patients with trauma who did not receive prehospital intravenous fluid infusion: a Japanese, nationwide, database study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Impact of Pre-Hospital Intravenous Infusion on Physiological Parameters in Severe Trauma Patients.Cureus · 2024Article
- Delta Shock Index and higher incidence of emergency surgery in older adults with blunt trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- 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 · 2022Article
- The impact of age and receipt antihypertensives to systolic blood pressure and shock index at injury scene and in the emergency department to predict massive transfusion in trauma patients.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Observational
- Observational
- Take Two: Second Systolic Blood Pressure Provides Prognostic Information in Trauma.Journal of emergencies, trauma, and shockArticle
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe shock index (SI) is defined as the ratio of heart rate/systolic blood pressure. This study aimed to determine the performance of delta shock index (ΔSI), a difference between SI upon arrival at the emergency room (ER) and that in the field, in predicting the need for massive transfusion (MT) among adult trauma patients with stable blood pressure.
methodsThis study included registered data from all trauma patients aged 20 years and above who were hospitalized from January 1, 2009 to December 31, 2016. Only patients who were transferred by emergency medical service from the accident site with a systolic blood pressure ≥ 90 mm Hg at the ER were included. The 7,957 enrolled trauma patients were divided into 2 groups, those who had received blood transfusion ≥ 10 U (MT, n = 82) and those who had not (non-MT, n = 7,875). The odds ratios with 95% confidence intervals for the need for MT by a given ΔSI were measured. The plot of specific receiver operating characteristic (ROC) curves was used to evaluate the best cutoff point of ΔSI that could predict the patient's probability of receiving MT.
resultsROC curve analysis showed that a ΔSI of 0.06 as the cutoff point had the highest AUC of 0.61, with a sensitivity of 0.415 and specificity of 0.841. Patients with a ΔSI ≥ 0.00 had a significant 1.8-fold increase in need for MT than those patients with a ΔSI less than 0.00 (1.4% vs. 0.8%, p = 0.01). The larger the ΔSI, the higher the odds of need for an MT. Using the cutoff point of ΔSI of 0.06, patients with a ΔSI ≥ 0.06 had a significant 3.7-fold increase in need for MT than those patients with a ΔSI less than 0.06 (2.7% vs. 0.7%, p < 0.001).
conclusionsThis study indicated that, in trauma patients with stable blood pressure at the ER, the accuracy of prediction of the requirement for MT by ΔSI is low. However, the size of the delta is significantly associated with need for MT and a lack of improvement in the patient's SI at the ER compared to that in the field significantly increases the odds of a need for MT.
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