ArticleTrauma surgery & acute care open2021
Prehospital shock index outperforms hypotension alone in predicting significant injury in trauma patients.
Article in Trauma surgery & acute care open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Shock index as predictor of massive transfusion and mortality in patients with trauma: a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Shock index as a predictor for mortality in trauma patients: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- Prehospital real-time AI for trauma mortality prediction: a multi-institutional and multi-national validation study.Nature communications · 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
- Analysis of factors associated with the outcome of hospitalisation in patients with traumatic pelvic fracture combined with shock.BMC surgery · 2025Article
- Shock Index as an indicator for blood transfusion or surgical intervention among multiple trauma patients in Jordan.Journal of medicine and life · 2025Article
- Traumatic Brain Injury as an Independent Predictor of Futility in the Early Resuscitation of Patients in Hemorrhagic Shock.Journal of clinical medicine · 2024Review
- Superiority of compensatory reserve measurement compared with the Shock index for early and accurate detection of reduced central blood volume status.The journal of trauma and acute care surgery · 2023Article
- Role of glucose/potassium ratio and shock index in predicting mortality in patients with isolated thoracoabdominal blunt trauma.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2022Observational
- The Pathophysiology and Management of Hemorrhagic Shock in the Polytrauma Patient.Journal of clinical medicine · 2021Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe American College of Surgeons Resources for Optimal Care of the Injured Patient recommends using hypotension, defined as systolic blood pressure ≤90 mm Hg, as an indicator of a full team trauma activation. We hypothesized that an elevated shock index (SI) predicts significant traumatic injuries better than hypotension alone.
methodsThis is a retrospective cohort study analyzing full team trauma activations between February 2018 and January 2020, excluding transfers and those who had missing values for prehospital blood pressure or heart rate. We reviewed patients' demographics, prehospital and emergency department vitals, injury pattern, need for operation, and clinical outcomes. The primary outcome was rate of significant injury defined as identified injured liver, spleen, or kidney, pelvis fracture, long bone fracture, significant extremity soft tissue damage, hemothorax, or pneumothorax.
resultsAmong 544 patients, 82 (15.1%) had prehospital hypotension and 492 had normal blood pressure. Of the patients with prehospital hypotension, 34 (41.5%) had a significant injury. There was no difference in age, gender, medical history, or injury pattern between the two groups. There was no difference between the two groups in rate of serious injury (41.5% vs. 46.1%, NS), need for emergent operation (31.7% vs. 28.1%, NS) or death (20.7% vs. 18.8%, NS). On the other hand, SI ≥1 was associated with increased rate of serious injury (54.6% vs. 43.4%, p=0.04). On a logistic regression analysis, prehospital hypotension was not associated with significant injury or need for emergent operation (OR 0.83, 95% CI 0.51 to 1.33 and OR 1.32, 95% CI 0.79 to 2.25, respectively). SI ≥1 was associated with both increased odds of significant injury and need for emergent operation (OR 1.57, 95% CI 1.01 to 2.44 and OR 1.64, 95% CI 1.01 to 2.66). DISCUSSION: SI was a better indicator and could replace hypotension to better categorize and triage patients in need of higher level of care. LEVEL OF EVIDENCE: Prognostic and epidemiologic, level III.
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