The usability of shock index and lactate in predicting mortality in multitrauma patients presenting to the emergency department

Çay, Ferhat; Çetinkaya, Hasan Basri

doi:10.38053/acmj.1075349

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…Moreover, the initial assessment of the shock index and lactate level at ED admission could be used as important prognostic markers of mortality in polytrauma patients. 30 An earlier study from our center reported the necessity of blood transfusion as an early predictor of head injury and advanced age as an independent predictor of late mortality. 4 Our results differ from those of previously published studies.…”

Section: Discussionmentioning

confidence: 90%

Time and Risk Factors of Trauma-Related Mortality: A 5-Year Retrospective Analysis From a National Level I Trauma Center

Asim,

El-Menyar,

Abdelrahman

et al. 2024

J Intensive Care Med

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Background: We aimed to analyze in-hospital timing and risk factors for mortality in a level 1 trauma center. Methods: This is a retrospective analysis of all trauma-related mortality between 2013 and 2018. Patients were divided and analyzed based on the time of mortality (early (≤48 h) vs late (>48 h)), and within different age groups. Multivariate regression analysis was performed to predict in-hospital mortality. Results: 8624 trauma admissions and 677 trauma-related deaths occurred (47.7% at the scene and 52.3% in-hospital). Among in-hospital mortality, the majority were males, with a mean age of 35.8 ± 17.2 years. Most deaths occurred within 3–7 days (35%), followed by 33% after 1 week, 20% on the first day, and 12% on the second day of admission. Patients with early mortality were more likely to have a lower Glasgow coma scale, a higher shock index, a higher chest and abdominal abbreviated injury score, and frequently required exploratory laparotomy and massive blood transfusion ( P < .005). The injury severity scores and proportions of head injuries were higher in the late mortality group than in the early group. The severity of injuries, blood transfusion, in-hospital complications, and length of intensive care unit stay were comparable among the age groups, whereas mortality was higher in the age group of 19 to 44. The higher proportions of early and late in-hospital deaths were evident in the age group of 24 to 29. In multivariate analysis, the shock index (OR 2.26; 95%CI 1.04-4.925; P = .04) was an independent predictor of early death, whereas head injury was a predictor of late death (OR 4.54; 95%CI 1.92-11.11; P = .001). Conclusion: One-third of trauma-related mortalities occur early after injury. The initial shock index appears to be a reliable hemodynamic indicator for predicting early mortality. Therefore, timely hemostatic resuscitation and appropriate interventions for bleeding control may prevent early mortality.

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Section: Discussionmentioning

confidence: 90%

Time and Risk Factors of Trauma-Related Mortality: A 5-Year Retrospective Analysis From a National Level I Trauma Center

Asim,

El-Menyar,

Abdelrahman

et al. 2024

J Intensive Care Med

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“…In a study evaluating patients admitted to the emergency department with multitrauma, SI was found to be an important predictor of mortality. The cut-off value of SI for mortality was 1.14, AUC: 0.738, 95% CI: 0.637–0.824, sensitivity 91.25%, specificity 53.85% [ 18 ]. In a study examining geriatric trauma patients admitted to the emergency department, the superiority of SI, MSI, and ASI in predicting mortality was proven.…”

Section: Discussionmentioning

confidence: 99%

Vital indicators in predicting burn mortality: A comparison of shock indices and burn shock indices

İÇER,

GÜNDÜZ,

GÜLOĞLU

et al. 2023

Turkish Journal of Medical Sciences

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Background/aim In many studies, shock indices have proven to be good tools for predicting mortality. In the present study, burn shock index (BSI), percentage of total body surface area burned (TBSA%) multiplied by shock index; burn modified shock index (BMSI), TBSA% multiplied by modified shock index; burn age shock index (BASI), TBSA% multiplied by age shock index; burn rivers shock index (BrSI), TBSA% multiplied by rivers shock index; burn rivers shock index multiplied by Glasgow Coma Scale score (BrSIG) were examined in burn patients. We defined these burn shock indices for the first time. This study aimed to evaluate the effectiveness of shock indices and burn shock indices in predicting mortality in burn patients. Materials and methods This study examines retrospectively of burn patients admitted to the emergency department of Dicle University Hospital between January 2010 and December 2022. The patients’ vital signs were obtained at the time of presentation to the emergency department, and shock indices were calculated. The effectiveness of shock indices in predicting mortality was compared. Results A total of 2445 patients were included in the study. Of the patients, 1793 were pediatric, and 652 were adults. BSI (AUC: 0.872, 95% confidence interval (CI): 0.812–0.931, p < 0.001) had the highest area under the curve (AUC) value in predicting mortality in children. The optimal cut-off value for BSI in children was 21.79 and its was sensitivity 83.05%, specificity 79.64%, positive predictive value (PPV) 12.19%, negative predictive value (NPV) 99.28%. In adults, BASI had the highest value of AUC (AUC: 0.936, 95% CI: 0.887–0.984, p < 0.001). The optimal cut-off value for BASI in adults was 62.5 and its sensitivity was 86.49%, specificity was 91.71%, PPV was 38.55%, and NPV was 99.12%. Conclusion Shock indices are easy to calculate and effective in predicting mortality in burn patients admitted to the emergency department. Among the shock indices in the study, BSI was the best in predicting mortality in children, and BASI was the best in adults.

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“…Additionally, it may differ depending on the shock index and serum lactate level measured in multitrauma patients. 20,21 When the immunomodulatory and immunotoxic effects of phototherapy were examined, it was shown that especially the number of CD4 lymphocytes increased after phototherapy.…”

Section: Discussionmentioning

confidence: 99%

Prognostic evaluation of newborns with neonatal hyperbilirubinemia

ÇAY,

KEMER

2023

Journal of Medicine and Palliative Care

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Aims: We aimed to investigate the effect of phototherapy treatment by showing that it increases systemic inflammation and changes in NLR (neutrophil count/lymphocyte count), PLO (platelet count/lymphocyte count), systemic Inflammation Index (platelet count × neutrophil count/lymphocyte count ratio) in peripheral blood. Methods: It was conducted at Balıkesir University Health Practice and Research Hospital between April 2023 and August 2023. 60 babies with a gestational age of ≥36 weeks and a birth weight of ≥2500 g were included in the study. Results: A statistically significant difference was detected between WBC, lymphocyte count, monocyte count, neutrophil count, lymphocyte/monocyte, systemic inflammatory index before and after phototherapy (p

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The usability of shock index and lactate in predicting mortality in multitrauma patients presenting to the emergency department

Cited by 5 publications

References 20 publications

Time and Risk Factors of Trauma-Related Mortality: A 5-Year Retrospective Analysis From a National Level I Trauma Center

Time and Risk Factors of Trauma-Related Mortality: A 5-Year Retrospective Analysis From a National Level I Trauma Center

Vital indicators in predicting burn mortality: A comparison of shock indices and burn shock indices

Prognostic evaluation of newborns with neonatal hyperbilirubinemia

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