The efect of time of measurement on the discriminant ability for mortality in trauma of a pre-hospital shock index multiplied by age and divided by the Glasgow Coma Score: a registry study
Dublin Core
Title
The efect of time of measurement on the discriminant ability for mortality in trauma of a pre-hospital shock index multiplied by age and divided by the Glasgow Coma Score: a registry study
Subject
Emergency medical services, Critical care, Shock index
Description
Background: The shock index (SI) and its derivatives have been shown to predict mortality in severely injured
patients, both in pre-hospital and in-hospital settings. However, the impact of the time of measurement on the
discriminative ability of the pre-hospital SI is unknown. The aim of this study was to evaluate whether the time of
measurement infuences the discriminative ability of the SI multiplied by age (SIA) and divided by the Glasgow Coma
Score (SIA/G).
Methods: Registry data were obtained from the national helicopter emergency medical services (HEMS) on trauma
patients aged≥18 years. The SI values were calculated based on the frst measured vitals of the trauma patients by
the HEMS unit. The discriminative ability of the SIA/G, with 30-day mortality as the endpoint, was evaluated according
to diferent delay times (0−19, 20−39 and≥40 min) from the initial incident. Sub-group analyses were performed
for trauma patients without a traumatic brain injury (TBI), patients with an isolated TBI and patients with polytrauma,
including a TBI.
Results: In total, 3,497 patients were included in the study. The SIA/G was higher in non-survivors (median 7.8 [interquartile range 4.7–12.3] vs. 2.4 [1.7–3.6], P<0.001). The overall area under the receiver operator characteristic curve
(AUROC) for the SIA/G was 0.87 (95% CI: 0.85–0.89). The AUROC for the SIA/G was similar in the short (0.88, 95% CI:
0.85–0.91), intermediate (0.86, 95% CI: 0.84–0.89) and long (0.86, 95% CI: 0.82–0.89) measurement delay groups. The
fndings were similar in the three trauma sub-groups.
Conclusions: The discriminative ability of the SIA/G in predicting 30-day mortality was not signifcantly afected by
the measurement time of the index in the pre-hospital setting. The SIA/G is a simple and reliable tool for assessing the
risk of mortality among severely injured patients in the pre-hospital setting
patients, both in pre-hospital and in-hospital settings. However, the impact of the time of measurement on the
discriminative ability of the pre-hospital SI is unknown. The aim of this study was to evaluate whether the time of
measurement infuences the discriminative ability of the SI multiplied by age (SIA) and divided by the Glasgow Coma
Score (SIA/G).
Methods: Registry data were obtained from the national helicopter emergency medical services (HEMS) on trauma
patients aged≥18 years. The SI values were calculated based on the frst measured vitals of the trauma patients by
the HEMS unit. The discriminative ability of the SIA/G, with 30-day mortality as the endpoint, was evaluated according
to diferent delay times (0−19, 20−39 and≥40 min) from the initial incident. Sub-group analyses were performed
for trauma patients without a traumatic brain injury (TBI), patients with an isolated TBI and patients with polytrauma,
including a TBI.
Results: In total, 3,497 patients were included in the study. The SIA/G was higher in non-survivors (median 7.8 [interquartile range 4.7–12.3] vs. 2.4 [1.7–3.6], P<0.001). The overall area under the receiver operator characteristic curve
(AUROC) for the SIA/G was 0.87 (95% CI: 0.85–0.89). The AUROC for the SIA/G was similar in the short (0.88, 95% CI:
0.85–0.91), intermediate (0.86, 95% CI: 0.84–0.89) and long (0.86, 95% CI: 0.82–0.89) measurement delay groups. The
fndings were similar in the three trauma sub-groups.
Conclusions: The discriminative ability of the SIA/G in predicting 30-day mortality was not signifcantly afected by
the measurement time of the index in the pre-hospital setting. The SIA/G is a simple and reliable tool for assessing the
risk of mortality among severely injured patients in the pre-hospital setting
Creator
Mikael Laaksonen, Johannes Björkman, Timo Iirola, Lasse Raatiniemi and Jouni Nurmi
Publisher
BMC Emergency Medicine
Date
(2022) 22:189
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Mikael Laaksonen, Johannes Björkman, Timo Iirola, Lasse Raatiniemi and Jouni Nurmi, “The efect of time of measurement on the discriminant ability for mortality in trauma of a pre-hospital shock index multiplied by age and divided by the Glasgow Coma Score: a registry study,” Repository Horizon University Indonesia, accessed April 4, 2025, https://repository.horizon.ac.id/items/show/4313.