Observational studyPloS one2021
Association between prehospital field to emergency department delta shock index and in-hospital mortality in patients with torso and extremity trauma: A multinational, observational study.
Observational study in PloS one, 2021. 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.
What it found
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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
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- 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
- Association between total prehospital time and early mortality in patients with severe torso trauma: a retrospective study at an urban Emergency and Critical Care Center.International journal of emergency medicine · 2026Article
- 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
- Article
- Gender Disparities in Trauma Patients With an Elevated Shock Index at a Rural Appalachian Trauma Center.Cureus · 2025Article
- Delta shock index predicts injury severity, interventions, and outcomes in trauma patients: A 10-year retrospective observational study.World journal of critical care medicine · 2024Article
- Impact of Pre-Hospital Intravenous Infusion on Physiological Parameters in Severe Trauma Patients.Cureus · 2024Article
- Article
- Evaluating the Shock Index, Revised Assessment of Bleeding and Transfusion (RABT), Assessment of Blood Consumption (ABC) and novel PTTrauma score to predict critical transfusion threshold (CAT) in penetrating thoracic trauma.Scientific reports · 2024Observational
- 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
- Shock index, modified shock index, age shock index score, and reverse shock index multiplied by Glasgow Coma Scale predicting clinical outcomes in traumatic brain injury: Evidence from a 10-year analysis in a single center.Frontiers in medicine · 2022Article
- Take Two: Second Systolic Blood Pressure Provides Prognostic Information in Trauma.Journal of emergencies, trauma, and shockArticle
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hemorrhage, a main cause of mortality in patients with trauma, affects vital signs such as blood pressure and heart rate. Shock index (SI), calculated as heart rate divided by systolic blood pressure, is widely used to estimate the shock status of patients with hemorrhage. The difference in SI between the emergency department and prehospital field can indirectly reflect urgency after trauma. We aimed to determine the association between delta SI (DSI) and in-hospital mortality in patients with torso or extremity trauma. Patients with DSI >0.1 are expected to be associated with high mortality. This retrospective, observational study used data from the Pan-Asian Trauma Outcomes Study. Patients aged 18-85 years with abdomen, chest, upper extremity, lower extremity, or external injury location were included. Patients from China, Indonesia, Japan, Philippines, Thailand, and Vietnam; those who were transferred from another facility; those who were transferred without the use of emergency medical service; those with prehospital cardiac arrest; those with unknown exposure and outcomes were excluded. The exposure and primary outcome were DSI and in-hospital mortality, respectively. The secondary and tertiary outcome was intensive care unit (ICU) admission and massive transfusion, respectively. Multivariate logistic regression analysis was performed to test the association between DSI and outcome. In total, 21,534 patients were enrolled according to the inclusion and exclusion criteria. There were 3,033 patients with DSI >0.1. The in-hospital mortality rate in the DSI >0.1 and ≤0.1 groups was 2.0% and 0.8%, respectively. In multivariate logistic regression analysis, the DSI ≤0.1 group was considered the reference group. The unadjusted and adjusted odds ratios of in-hospital mortality in the DSI >0.1 group were 2.54 (95% confidence interval [CI] 1.88-3.42) and 2.82 (95% CI 2.08-3.84), respectively. The urgency of traumatic hemorrhage can be determined using DSI, which can help hospital staff to provide proper trauma management, such as early trauma surgery or embolization.
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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.