目的

院前应用休克指数（SI）能否作为判断创伤患者风险的预测因素。

方法

采用回顾性队列研究，对2022年1月1日至2023年12月31日院前救治的创伤患者进行分析。对年龄≥18岁，符合纳入标准的创伤患者，在院前急救现场根据血压和心率计算休克指数，并根据院前休克指数评分评估患者的病情，判断休克指数能否判断创伤患者的病情趋势等。

结果

共纳入3 493例患者，其中男性2 086例（59.72%），女性1 407例（40.28%）；年龄14～88岁，平均（64.5±15.16）岁。钝器伤和穿透伤分别占所有外伤患者的90.98%和9.02%，87.20%的患者由交通伤导致，其他原因仅仅占12.80%。院前现场低（≤0.4）、正常［0.4＜休克指数（SI）＜1.0］和高（≥1.0）SI 组的比例分别为6.90%、86.37%和6.73%。所有患者中，共有77人（2.20%）在24 h内死亡。与低SI组低（SI≤0.4）比较，正常（0.4＜SI＜1.0）组患者病死率显著较低（P＜0.01），而高（≥1.0） SI 组的病死率则显著较高（P=0.03）。

结论

院前现场SI 正常（0.4＜SI＜1.0）的创伤患者，其24 h内病死率低于院前SI异常（SI≥1.0或SI≤0.4）的患者，而且高SI患者的病死率更加显著。

Objective

To explore the pre-hospital application of shock index （SI）as a predictor of the risk in trauma patients.

Methods

A retrospective study was conducted on trauma patients treated before hospital from January 1， 2022 to December 31， 2023.For trauma patients aged over 18 years and met the inclusion criteria， the shock index was calculated according to blood pressure and heart rate at the prehospital emergency site， and the patient's condition was evaluated according to the pre-hospital shock index score， so as to judge whether the shock index could judge the condition trend of trauma patients.

Results

A total of 3，493 patients were enrolled in this study， including 2，086 males （59.72%） and 1，407 females（40.28%）， aged 14-88 years， with average of （64.5±15.16） years.Blunt trauma and penetrating trauma accounted for 90.98% and 9.02% of all trauma cases， respectively.Generally speaking， 87.20% of patients were caused by traffic accidents， and other reasons only accounted for 12.80%.The proportions of low （≤0.4），normal （0.4＜SI＜1.0） and high （≥1.0） SI groups were 6.90%， 86.37% and 6.73% respectively.Among all patients， a total of 77（2.20%） died within 24 hours.Compared with the low SI group （SI≤0.4）， the mortality of patients in normal （0.4＜SI＜1.0） group was significantly lower （P＜0.01）， while the mortality of patients in high（≥1.0） SI group was significantly higher （P=0.03）.

Conclusion

The mortality of trauma patients with normal pre-hospital SI （0.4＜SI＜1.0） is lower than that of patients with abnormal pre-hospital SI （≥1.0 or≤0.4）within 24 hours， and the mortality of patients with high SI is significantly increased.