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Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study
The shock index (SI) predicts short-term mortality in trauma patients. Other shock indices have been developed to improve discriminant accuracy. The authors examined the discriminant ability of the SI, modified SI (MSI), and reverse SI multiplied by the Glasgow Coma Scale (rSIG) on short-term mortal...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389576/ https://www.ncbi.nlm.nih.gov/pubmed/37222717 http://dx.doi.org/10.1097/JS9.0000000000000287 |
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author | Chen, Tse-Hao Wu, Meng-Yu Do Shin, Sang Jamaluddin, Sabariah F. Son, Do Ngoc Hong, Ki Jeong Jen-Tang, Sun Tanaka, Hideharu Hsiao, Chien-Han Hsieh, Shang-Lin Chien, Ding-Kuo Tsai, Weide Chang, Wen-Han Chiang, Wen-Chu |
author_facet | Chen, Tse-Hao Wu, Meng-Yu Do Shin, Sang Jamaluddin, Sabariah F. Son, Do Ngoc Hong, Ki Jeong Jen-Tang, Sun Tanaka, Hideharu Hsiao, Chien-Han Hsieh, Shang-Lin Chien, Ding-Kuo Tsai, Weide Chang, Wen-Han Chiang, Wen-Chu |
author_sort | Chen, Tse-Hao |
collection | PubMed |
description | The shock index (SI) predicts short-term mortality in trauma patients. Other shock indices have been developed to improve discriminant accuracy. The authors examined the discriminant ability of the SI, modified SI (MSI), and reverse SI multiplied by the Glasgow Coma Scale (rSIG) on short-term mortality and functional outcomes. METHODS: The authors evaluated a cohort of adult trauma patients transported to emergency departments. The first vital signs were used to calculate the SI, MSI, and rSIG. The areas under the receiver operating characteristic curves and test results were used to compare the discriminant performance of the indices on short-term mortality and poor functional outcomes. A subgroup analysis of geriatric patients with traumatic brain injury, penetrating injury, and nonpenetrating injury was performed. RESULTS: A total of 105 641 patients (49±20 years, 62% male) met the inclusion criteria. The rSIG had the highest areas under the receiver operating characteristic curve for short-term mortality (0.800, CI: 0.791–0.809) and poor functional outcome (0.596, CI: 0.590–0.602). The cutoff for rSIG was 18 for short-term mortality and poor functional outcomes with sensitivities of 0.668 and 0.371 and specificities of 0.805 and 0.813, respectively. The positive predictive values were 9.57% and 22.31%, and the negative predictive values were 98.74% and 89.97%. rSIG also had better discriminant ability in geriatrics, traumatic brain injury, and nonpenetrating injury. CONCLUSION: The rSIG with a cutoff of 18 was accurate for short-term mortality in Asian adult trauma patients. Moreover, rSIG discriminates poor functional outcomes better than the commonly used SI and MSI. |
format | Online Article Text |
id | pubmed-10389576 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-103895762023-08-01 Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study Chen, Tse-Hao Wu, Meng-Yu Do Shin, Sang Jamaluddin, Sabariah F. Son, Do Ngoc Hong, Ki Jeong Jen-Tang, Sun Tanaka, Hideharu Hsiao, Chien-Han Hsieh, Shang-Lin Chien, Ding-Kuo Tsai, Weide Chang, Wen-Han Chiang, Wen-Chu Int J Surg Original Research The shock index (SI) predicts short-term mortality in trauma patients. Other shock indices have been developed to improve discriminant accuracy. The authors examined the discriminant ability of the SI, modified SI (MSI), and reverse SI multiplied by the Glasgow Coma Scale (rSIG) on short-term mortality and functional outcomes. METHODS: The authors evaluated a cohort of adult trauma patients transported to emergency departments. The first vital signs were used to calculate the SI, MSI, and rSIG. The areas under the receiver operating characteristic curves and test results were used to compare the discriminant performance of the indices on short-term mortality and poor functional outcomes. A subgroup analysis of geriatric patients with traumatic brain injury, penetrating injury, and nonpenetrating injury was performed. RESULTS: A total of 105 641 patients (49±20 years, 62% male) met the inclusion criteria. The rSIG had the highest areas under the receiver operating characteristic curve for short-term mortality (0.800, CI: 0.791–0.809) and poor functional outcome (0.596, CI: 0.590–0.602). The cutoff for rSIG was 18 for short-term mortality and poor functional outcomes with sensitivities of 0.668 and 0.371 and specificities of 0.805 and 0.813, respectively. The positive predictive values were 9.57% and 22.31%, and the negative predictive values were 98.74% and 89.97%. rSIG also had better discriminant ability in geriatrics, traumatic brain injury, and nonpenetrating injury. CONCLUSION: The rSIG with a cutoff of 18 was accurate for short-term mortality in Asian adult trauma patients. Moreover, rSIG discriminates poor functional outcomes better than the commonly used SI and MSI. Lippincott Williams & Wilkins 2023-04-19 /pmc/articles/PMC10389576/ /pubmed/37222717 http://dx.doi.org/10.1097/JS9.0000000000000287 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Original Research Chen, Tse-Hao Wu, Meng-Yu Do Shin, Sang Jamaluddin, Sabariah F. Son, Do Ngoc Hong, Ki Jeong Jen-Tang, Sun Tanaka, Hideharu Hsiao, Chien-Han Hsieh, Shang-Lin Chien, Ding-Kuo Tsai, Weide Chang, Wen-Han Chiang, Wen-Chu Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study |
title | Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study |
title_full | Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study |
title_fullStr | Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study |
title_full_unstemmed | Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study |
title_short | Discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the Glasgow coma scale on mortality in adult trauma patients: a PATOS retrospective cohort study |
title_sort | discriminant ability of the shock index, modified shock index, and reverse shock index multiplied by the glasgow coma scale on mortality in adult trauma patients: a patos retrospective cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10389576/ https://www.ncbi.nlm.nih.gov/pubmed/37222717 http://dx.doi.org/10.1097/JS9.0000000000000287 |
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