Delta shock index predicts injury severity,interventions,and outcomes in trauma patients:A 10-year retrospective observational study

作     者：Mohammad Asim Ayman El-Menyar Khalid Ahmed Mushreq Al-Ani Saji Mathradikkal Abubaker Alaieb Abdel Aziz Hammo Ibrahim Taha Ahmad Kloub Hassan Al-Thani 

作者机构：Department of SurgeryTrauma and Vascular Surgery SectionClinical ResearchHamad Medical CorporationDoha 3050Qatar Department of Clinical MedicineWeill Cornell MedicinePO Box 24144DohaQatar Department of SurgeryTrauma Surgery SectionHamad Medical CorporationDoha 3050Qatar 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志（英文）)

年 卷 期：2024年第13卷第4期

页      面：62-72页

学科分类：0401[教育学-教育学] 04[教育学] 

基　　金：The Medical Research Center(institutional review board MRC-01-21-990)approved the study protocol at Hamad Medical Corporation Doha Qatar 

主　　题：Delta shock index Trauma Injury severity scores Interventions Outcomes 

摘      要：BACKGROUND Most trauma occurs among young male subjects in *** examined the predictive values of the delta shock index(DSI),defined as the change in the shock index(SI)value from the scene to the initial reading in the emergency unit(i.e.,subtracting the calculated SI at admission from SI at the scene),at a Level 1 trauma *** To explore whether high DSI is associated with severe injuries,more interventions,and worse outcomes[i.e.,blood transfusion,exploratory laparotomy,ventilator-associated pneumonia,hospital length of stay(HLOS),and in-hospital mortality]in trauma *** A retrospective analysis was conducted after data were extracted from the National Trauma Registry between 2011 and *** were grouped based on DSI as low(≤0.1)or high(0.1).Data were analyzed and compared usingχ^(2) and Student’s *** between DSI and injury severity score(ISS),revised trauma score(RTS),abbreviated injury scale(AIS),Glasgow coma scale(GCS),trauma score-ISS(TRISS),HLOS,and number of transfused blood units(NTBU),were assessed using correlation coefficient *** diagnostic testing accuracy for predicting mortality was determined using the validity measures of the *** regression analysis was performed to identify predictors of *** This analysis included 13212 patients with a mean age of 33±14 years,and 24%had a high *** accounted for 91%of the study *** trauma activation level was higher in patients with a high DSI(38%vs 15%,P=0.001).DSI correlated with RTS(r=-0.30),TRISS(r=-0.30),NTBU(r=0.20),GCS(r=-0.24),ISS(r=0.22),and HLOS(r=0.14)(P=0.001 for all).High DSI was associated with significantly higher rates of intubation,laparotomy,ventilator-associated pneumonia,massive transfusion activation,and mortality than low *** mortality prediction,a high DSI had better specificity,negative predictive value,and negative likelihood ratio(77%,99%,and 0.49%,respectively).After adjusting for age,emerge