Shock index as a prognosticator for emergent surgical intervention and mortality in trauma patients in Johannesburg: A retrospective cohort study

Crawford, Richard; Kruger, Deirdré; Moeng, Maeyane Stephens

doi:10.1016/j.amsu.2021.102710

Cited by 3 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies from the 1990s showed that patients undergoing diagnostic laparoscopy (DL) had a high rate of missed injury (41%) [ 7 , 11 ]. However, as laparoscopic instruments and expertise improve, the reported rates of missed injuries have decreased to as low as 0.12% [ 7 , 11 , 15 ]. This decline has been ascribed to the introduction of a systematic examination in trauma laparoscopy [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Introduction of Laparoscopy in an Urban High‐Volume Sub‐Saharan Trauma Centre

2023

View full text Add to dashboard Cite

Introduction Trauma is a major disease burden in low and middle-income countries like South Africa. Abdominal trauma is one of the leading reasons for emergency surgery. The standard of care for these patients is a laparotomy. In selected trauma patients, laparoscopy has both diagnostic and therapeutic usage. The trauma burden and the number of cases seen in a busy trauma unit make laparoscopy challenging. Aim We wanted to describe our journey with laparoscopy in the management of abdominal trauma in a busy urban trauma unit in Johannesburg, South Africa. Methods We reviewed all trauma patients who underwent diagnostic laparoscopy (DL) or therapeutic laparoscopy (TL) between 01 January 2017 and 31 October 2020 for blunt and penetrating abdominal trauma. The demographic data, indications for laparoscopy, injuries identified, procedures performed, intraoperative laparoscopic complications, conversion to laparotomy, morbidity, and mortality were evaluated. Results A total of 54 patients who had laparoscopy were included in the study. The median age was 29 years (IQR 25–25). Most injuries were penetrating 85.2% (n = 46/54) and 14.8% blunt trauma. Most patients were males, 94.4% (n = 51/54). Indications for laparoscopy included diaphragm evaluation (40.7%), pneumoperitoneum for evaluation of potential bowel injury (16.7%), free fluid with no evidence of solid organ injury (12.9%) and colostomy (5.5%). There were 8 (14.8%) cases converted to laparotomy. There were no missed injuries or mortality in the study group. Conclusion Laparoscopy in selected trauma patients is safe even in a busy trauma unit. It is associated with less morbidity and shortened hospital length of stay.

show abstract

Section: Discussionmentioning

confidence: 99%

“…We see significant penetrating abdominal trauma in our institution [ 14 , 15 ]. The emergency workload further adds pressure on theatre availability time.…”

Section: Introductionmentioning

confidence: 99%

Introduction of Laparoscopy in an Urban High‐Volume Sub‐Saharan Trauma Centre

2023

View full text Add to dashboard Cite

show abstract

“…Many studies show that the SI obtained by dividing the heart rate by the systemic blood pressure, which Allgower first described in 1976, is more reliable in determining trauma severity than that of hypotension and tachycardia alone. [ 11 , 12 , 23 – 25 ] Lammers et al[ 26 ] reported that SI and injury severity score (ISS) were similarly effective in predicting surgical necessity and mortality in patients with trauma. In addition, Inal et al[ 27 ] reported that SI effectively determines prognosis in patients followed up in the intensive care unit after emergency surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Richard Crawford et al reported that SI successfully predicted surgical necessity and mortality. [ 12 ] However, Shibahashi et al[ 10 ] found that the efficacy of SI was more limited in older patients and emphasized the SI modified for age. In addition, Il-Jae Wang et al[ 28 ] showed that SI (preSI) evaluated pre-hospital is effective in estimating mortality.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Role of Glucose/Potassium Ratio and Shock Index in Predicting Mortality in Patients with Isolated Thoracoabdominal Blunt Trauma

Turan¹

2022

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

BACKGROUND: The aim of this study, investigate the prognostic value of shock index (SI), which has been accepted for a long time, and glucose-potassium ratio (GPR), which has limited data in patients with trauma and those with isolated blunt thoracoabdominal trauma. METHODS: This retrospective observational study was conducted at the tertiary reference hospital. Consecutive patients aged 18 years and older treated for blunt thoracoabdominal trauma in the emergency department between August 2020 and February 2022 were included in the study. The ability of GPRs obtained from arterial blood gases and SI levels on admission to predict mortality and indication for surgery was evaluated by calculating areas under receiver operating characteristic curves Area under the curve (AUCs). RESULTS: A total of 102 patients, of which 91 in the survivor group and 11 in the non-survivor group, were analyzed. The AUCs for estimating mortality with GPR and SI were 0.854 (95% confidence interval [CI], 0.742–0.967) and 0.809 (95%, 0.666–0.952), respectively. The AUCs of GPR and SI to estimate the indication for surgery were 0.761 (95% CI, 0.657–0.864) and 0.582 (95% CI, 0.416–0.747), respectively. CONCLUSION: This study reported the efficacy of SI and GPR in predicting surgical indication and mortality in patients with isolated blunt thoracoabdominal trauma and the superior predictive role of GPR over SI.

show abstract

Shock index to predict outcomes in patients with trauma following traffic collisions: a retrospective cohort study

Liao,

Ho,

Lin

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose:Taiwan, which has a rate of high vehicle ownership, faces significant challenges in managing trauma caused by traffic collisions. In Taiwan, traffic collisions contribute significantly to morbidity and mortality, with a high incidence of severe bleeding trauma. The shock index (SI) and the modified shock index (MSI) have been proposed as early indicators of hemodynamic instability. In this study, we aimed to assess the efficacy of SI and MSI in predicting adverse outcomes in patients with trauma following traffic collisions. Methods: This retrospective cohort study was conducted at Chi Mei Hospital from January 2015 to December 2020. The comprehensive analysis included 662 patients, with data collected on vital signs and outcomes such as mortality, blood transfusion, emergent surgical intervention (ESI), transarterial embolization (TAE), and intensive care unit (ICU) admission. Optimal cutoff points for SI and MSI were identified by calculating the Youden index. Logistic regression analysis was used to assess outcomes, adjusting for demographic and injury severity variables. Results:An SI threshold of 1.11 was associated with an increased risk of mortality, while an SI of 0.84 predicted the need for blood transfusion in the context of traffic collisions. Both SI and MSI demonstrated high predictive power for mortality and blood transfusion, with acceptable accuracy for TAE, ESI, and ICU admission. Logistic regression analyses confirmed the independence of SI and MSI as risk factors for adverse outcomes, thus, providing valuable insights into their clinical utility. Conclusions:SI and MSI are valuable tools for predicting mortality and blood transfusion needs in patients with trauma due to traffic collisions. These findings advance the quality of care for patients with trauma during their transition from the emergency room to the ICU, facilitating prompt and reliable decision-making processes and improving the care of patients with trauma.

show abstract

Shock index as a prognosticator for emergent surgical intervention and mortality in trauma patients in Johannesburg: A retrospective cohort study

Cited by 3 publications

References 24 publications

Introduction of Laparoscopy in an Urban High‐Volume Sub‐Saharan Trauma Centre

Introduction of Laparoscopy in an Urban High‐Volume Sub‐Saharan Trauma Centre

Role of Glucose/Potassium Ratio and Shock Index in Predicting Mortality in Patients with Isolated Thoracoabdominal Blunt Trauma

Shock index to predict outcomes in patients with trauma following traffic collisions: a retrospective cohort study

Contact Info

Product

Resources

About