A prehospital shock index for trauma correlates with measures of hospital resource use and mortality

• Published in: Surgery 2012-09, Vol.152 (3), p.473-476
• Main Authors: McNab, Andrea, MD, Burns, Bracken, DO, Bhullar, Indermeet, MD, Chesire, David, PhD, Kerwin, Andrew, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Epidemiology; Female; Florida; General aspects; Health Resources - utilization; Hospital Mortality; Humans; Injury Severity Score; Length of Stay - statistics & numerical data; Male; Medical sciences; Middle Aged; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Shock - mortality; Surgery; Trauma Centers - statistics & numerical data; Triage - utilization; Young Adult
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2012.07.010

Background The assessment and treatment of trauma patients begins in the prehospital environment. Studies have validated the shock index as a correlate for mortality and the identification of shock in trauma patients. We investigated the use of the first shock index obtained in the prehospital environment and the first shock index obtained upon arrival in the trauma center as correlates for other outcomes to evaluate its usefulness as a triage tool. Methods This is a retrospective review of data from a level I trauma center. Prehospital and trauma center shock indices for 16,269 patients were evaluated as correlates for duration of hospital stay, duration of stay in the intensive care unit, the number of ventilator days, blood product use, and destination of transfer from the trauma center. Results Pearson correlation coefficients revealed that the relationship of prehospital and trauma center shock indices were correlates for duration of hospital stay, duration of stay in the intensive care unit, the number of ventilator days, and blood product use. A chi-square analysis found that shock indices ≥0.9 indicate a higher likelihood of disposition to the intensive care unit, operating room, or death. Conclusion A prehospital shock index for trauma correlates with measures of hospital resource use and mortality. A prospective study is needed to determine the use of this measure as a triage tool.