Shock index, pediatric age-adjusted (SIPA) is more accurate than age-adjusted hypotension for trauma team activation

• Published in: Surgery 2017-03, Vol.161 (3), p.803-807
• Main Authors: Acker, Shannon N., MD, Bredbeck, Brooke, MD, Partrick, David A., MD, Kulungowski, Ann M., MD, Barnett, Carlton C., MD, Bensard, Denis D., MD
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Blood Transfusion; Child; Child, Preschool; Female; Humans; Hypotension - diagnosis; Hypotension - etiology; Hypotension - therapy; Injury Severity Score; Intubation, Intratracheal; Male; Needs Assessment; Retrospective Studies; Shock - diagnosis; Shock - etiology; Shock - therapy; Surgery; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - physiopathology; Wounds, Nonpenetrating - therapy
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2016.08.050

Background We demonstrated previously that shock index, pediatric age-adjusted identifies severely injured children accurately after blunt trauma. We hypothesized that an increased shock index, pediatric age-adjusted would identify more accurately injured children requiring the highest trauma team activation than age-adjusted hypotension. Methods We reviewed all children age 4–16 admitted after blunt trauma with an injury severity score ≥15 from January 2007–June 2013. Criteria used as indicators of need for activation of the trauma team included blood transfusion, emergency operation, or endotracheal intubation within 24 hours of admission. Shock index, pediatric age-adjusted represents maximum normal shock index based on age. Cutoffs included shock index >1.22 (ages 4–6), >1.0 (7–12), and >0.9 (13–16). Age-adjusted cutoffs for hypotension were as follows: systolic blood pressure