NYMC Faculty Publications

Pre-Hospital Shock Index Correlates with Transfusion, Resource Utilization and Mortality; The Role of Patient First Vitals

DOI

10.1016/j.amjsurg.2019.08.028

Journal Title

American Journal of Surgery

First Page

1169

Last Page

1174

Document Type

Article

Publication Date

December 2019

Department

Surgery

Abstract

INTRODUCTION: The aim of our study was to evaluate if pre-hospital shock index (SI) can predict transfusion requirements, resource utilization and mortality in trauma patients. METHODS: We performed a 2-year analysis of all adult trauma patients in the TQIP database. Shock index was calculated by dividing heart-rate over systolic blood pressure. Patients were divided into two groups pre-hospital SI1. Regression and ROC curve analyses were performed. RESULTS: 144951 patients were included in the study. Mean age was 45+/-34 years, 61% were male, 84.7% had blunt injuries and median ISS was 13 [9-17]. Overall 9.1% of the patients had a pre-hospital SI>1. Patients with pre-hospital SI>1 had higher likelihood of requiring massive transfusion (25% vs. 0.012%, p1. Regression and ROC curve analyses were performed. RESULTS: 144951 patients were included in the study. Mean age was 45+/-34 years, 61% were male, 84.7% had blunt injuries and median ISS was 13 [9-17]. Overall 9.1% of the patients had a pre-hospital SI>1. Patients with pre-hospital SI>1 had higher likelihood of requiring massive transfusion (25% vs. 0.012%, p1. Regression and ROC curve analyses were performed. RESULTS: 144951 patients were included in the study. Mean age was 45+/-34 years, 61% were male, 84.7% had blunt injuries and median ISS was 13 [9-17]. Overall 9.1% of the patients had a pre-hospital SI>1. Patients with pre-hospital SI>1 had higher likelihood of requiring massive transfusion (25% vs. 0.012%, p1. Regression and ROC curve analyses were performed. RESULTS: 144951 patients were included in the study. Mean age was 45+/-34 years, 61% were male, 84.7% had blunt injuries and median ISS was 13 [9-17]. Overall 9.1% of the patients had a pre-hospital SI>1. Patients with pre-hospital SI>1 had higher likelihood of requiring massive transfusion (25% vs. 0.012%, p1 had higher mortality (12.3% vs. 5.2%, p<0.001) and were more likely to be discharged to Rehab/SNF (34.6% vs. 21.4%, p<0.001). CONCLUSIONS: Pre-hospital SI predicts trauma-center resource utilization and can guide patient triage and trauma resource recruitment.

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