Abstract:

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.

Key words: Pre-hospital care, Trauma, Shock index, Predictive value