Journal of Emergencies, Trauma, and Shock
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Year : 2022  |  Volume : 15  |  Issue : 1  |  Page : 17-22

Outcomes of trauma patients present to the emergency department with a Shock Index of ≥1.0

1 Trauma Center, King Saud Medical City, Riyadh, Saudi Arabia
2 Research and Innovation Center, King Saud Medical City, Riyadh, Saudi Arabia
3 Department of Trauma, University Medical Center Utrecht, Utrecht, Netherlands

Correspondence Address:
Dr. Sharfuddin Chowdhury
Trauma Center, King Saud Medical City, 7790 Al Imam Abdul Aziz Ibn Muhammad Ibn Saud, Ulaishah, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jets.jets_86_21

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Introduction: The study aimed primarily to evaluate the association between the initial shock index (SI) ≥1.0 with blood transfusion requirement in the emergency department (ED) after acute trauma. The study's secondary aim was to look at the outcomes regarding patients' disposition from ED, intensive care unit (ICU) and hospital length of stay, and deaths. Methods: It was a retrospective, cross-sectional study and utilized secondary data from the Saudi Trauma Registry (STAR) between September 2017 and August 2020. We extracted the data related to patient demographics, mechanism of injuries, the intent of injuries, mode of arrival at the hospital, characteristics on presentation to ED, length of stay, and deaths from the database and compared between two groups of SI <1.0 and SI ≥1.0. A P < 0.05 was statistically considered significant. Results: Of 6667 patients in STAR, 908 (13.6%) had SI ≥1.0. With SI ≥1.0, there was a significantly higher incidence of blood transfusion in ED compared to SI <1.0 (8.9% vs. 2.4%, P < 0.001). Furthermore, SI ≥ 1.0 was associated with significant ICU admission (26.4% vs. 12.3%, P < 0.001), emergency surgical intervention (8.5% vs. 2.8%, P < 0.001), longer ICU stay (5.0 ± 0.36 vs. 2.2 ± 0.11days, P < 0.001), longer hospital stays (14.8 ± 0.61 vs. 13.3 ± 0.24 days, P < 0.001), and higher deaths (8.4% vs. 2.8%, P < 0.001) compared to the patient with SI <1.0. Conclusions: In our cohort, a SI ≥ 1.0 on the presentation at the ED carried significantly worse outcomes. This simple calculation based on initial vital signs may be used as a screening tool and therefore incorporated into initial assessment protocols to manage trauma patients.

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