Shock index, modified shock index, age shock index score, and reverse shock index multiplied by Glasgow Coma Scale predicting clinical outcomes in traumatic brain injury: Evidence from a 10-year analysis in a single center

Abstract

ObjectivesEarly identification of traumatic brain injury (TBI) patients at a high risk of mortality is very important. This study aimed to compare the predictive accuracy of four scoring systems in TBI, including shock index (SI), modified shock index (MSI), age-adjusted shock index (ASI), and reverse shock index multiplied by the Glasgow Coma Scale (rSIG).Patients and methodsThis is a retrospective analysis of a registry from the Taipei Tzu Chi trauma database. Totally, 1,791 patients with TBI were included. We investigated the accuracy of four major shock indices for TBI mortality. In the subgroup analysis, we also analyzed the effects of age, injury mechanism, underlying diseases, TBI severity, and injury severity.ResultsThe predictive accuracy of rSIG was significantly higher than those of SI, MSI, and ASI in all the patients [area under the receiver operating characteristic curve (AUROC), 0.710 vs. 0.495 vs. 0.527 vs. 0.598], especially in the moderate/severe TBI (AUROC, 0.625 vs. 0.450 vs. 0.476 vs. 0.529) and isolated head injury populations (AUROC 0.689 vs. 0.472 vs. 0.504 vs. 0.587). In the subgroup analysis, the prediction accuracy of mortality of rSIG was better in TBI with major trauma [Injury Severity Score (ISS) ≥ 16], motor vehicle collisions, fall injury, and healthy and cardiovascular disease population. rSIG also had a better prediction effect, as compared to SI, MSI, and ASI, both in the non-geriatric (age < 65 years) and geriatric (age ≥ 65 years).ConclusionrSIG had a better prediction accuracy for mortality in the overall TBI population than SI, MSI, and ASI. Although rSIG have better accuracy than other indices (ROC values indicate poor to moderate accuracy), the further clinical studies are necessary to validate our results.

Use of Shock Index, Modified Shock Index, and Age-Adjusted Shock Index for Detection of Postpartum Hemorrhage

“…Age-adjusted SI is obtained by multiplying the shock index by age. It can be used to predict unfavorable outcomes in patients with hemorrhage [31]. Age is an important factor in outcomes after hemorrhage [32].…”

Reverse shock index multiplied by simplified motor score as a predictor of clinical outcomes for patients with COVID-19

“…The GCS is commonly used to evaluate a patient’s level of consciousness and is a stronger predictor of mortality than SBP, respiratory rate (RR), and age [ 29 , 30 ]. The rSI-GCS is a useful and accurate triage tool for detecting hypovolemic shock and can also be used to predict the need for massive blood transfusion, coagulopathy, in-hospital mortality, and 24-h mortality in patients with trauma [ 7 , 8 , 10 , 31 – 36 ]. However, utilizing the GCS during prehospital triage is a time-consuming process.…”

Validity of the Reverse Shock Index multiplied by the Glasgow Coma Scale score for determining mortality in patients with severe trauma in the prehospital environment

“…El Índice de Shock Reverso por Glasgow (rSIG) es una escala reciente que evalúa tanto el componente hemodinámico como el neurológico. Cuenta con evidencia que lo respalda como predictor de mortalidad en los pacientes con ETG [6][7][8][9][10][11][12] y diversos estudios demuestran su capacidad de predicción de la necesidad de transfusión masiva 7 , así como su utilidad en pacientes con traumatismo craneoencefálico (TCE) 8 .…”