The value of traditional vital signs, shock index, and age-based markers in predicting trauma mortality

Abstract

Prognostic/epidemiologic study, level III.

Multivariate analysis of patients with blunt trauma and possible factors affecting mortality

“…affecting mortality. [29][30][31][32][33] To the best of the knowledge of the researchers, ISS >40 and RTS <4.5 dramatically increase mortality risk. [31][32][33] In the present study, mean ISS was statistically significantly higher in patients who were urgently operated on, compared to those who were not operated on, and exitus patients were compared to survivors (p<0.001).…”

Association of Prehospital Shock Index and Trauma Bay Uncrossmatched Red Blood Cell Transfusion With Multiple Transfusion

“…In the recent PROMMTT and PROPPR studies of massive transfusion timing and transfusion ratios, median time to death from bleeding was 2.3-2.6 hrs . This has important implications for trauma nurses because they frequently provide the early resuscitative care of the injured patient, and thus may significantly From Bruijns et al, 2013;Burman and Cotton, 2012 ;Callcut et al, 2011Callcut et al, , 2013Guyette et al, 2015 ;Larson et al, 2010 ;Maegele et al, 2012 ;McLaughlin et al, 2008 ;Nunez et al, 2009 ;Pohlman et al, 2015 ;Rainer et al, 2011 ;Riha and Schreiber, 2013 ;Ruchholtz et al, 2006 ;Schreiber et al, 2007 ;Yucel et al, 2006 . impact outcome. For trauma nurses, a simple means to anticipate a potentially bleeding patient may be helpful.…”

“…Previous studies of SI and trauma evaluated association with mortality, or if evaluating association with transfusion, used SI calculated in the ED instead of, or compared to, SI calculated from prehospital vital signs ( Bruijns et al, 2013 ;Cannon et al, 2009 ;Mutscher et al, 2013 ). McNab, Burns, Bhullar, Chesire, and Kerwin (2012) reported a prehospital SI of 0.9 or more to be associated with increased "hospital resource use" (p. 473), including any amount of blood transfusion during the hospital stay, but did not evaluate association with massive or MULT.…”

“…Prehospital vital signs are standard criteria commonly used for trauma team activation ( Bruijns, Guly, Bouamra, Lecky, & Lee, 2013 ). SI, heart rate divided by systolic blood pressure, has been used as a marker for significant injury even when heart rate and blood pressure are normal ( Burman & Cotton, 2012 ;Cannon et al, 2009 ;Mutscher et al, 2013 ;Vandromme et al, 2011a ).…”

Understanding the Vital Signs: BP, HR, RR, TEMP, SaO2 … and SV

“…A combination of these signs is likely to perform better than each vital sign alone. Indeed the Shock Index (SI) defined by the HR/SBP (normal 0.5-0.7) has been shown to have a high sensitivity and specificity for predicting poor outcomes and performs better than any of the vital signs alone [95]. Bleyer et al evaluated the prognostic implications of individual patient vital signs during 27,722 patient hospitalizations [1].…”