Assessing Reverse Shock Index as a Survival Predictor for Trauma Patients in Emergency Settings: A Retrospective Observational Study
Correspondence Address :
Dr. Anuja Agrawal,
Professor and Head, Department of Emergency Medicine, Smt. Bhikhiben Kanjibhai Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara-391760, Gujarat, India.
E-mail: anujagyl@gmail.com
Introduction: Identifying trauma patients with shock is crucial, as early intervention and prompt treatment improve patient prognosis and survival. To address this, the ratio of Systolic Blood Pressure (SBP) and Heart Rate (HR), known as the Reverse Shock Index (RSI), is measured.
Aim: To evaluate the effectiveness of RSI calculation in assessing prognosis.
Materials and Methods: This was a retrospective observational study in which data were retrospectively collected on trauma patients treated in the Emergency Room (ER) at Dhiraj Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India, from January 2021 to December 2022. Patients involved in road traffic accidents, fall from a height of ≥6 m, assault, and machinery injuries were included. Upon arrival, vital signs such as HR, SBP, Respiratory Rate (RR), Glasgow Coma Scale (GCS), associated injuries, and in-hospital mortality were documented. Any resuscitative procedures required, such as Cardiopulmonary Resuscitation (CPR), intubation, oxygen therapy, chest tube insertion, and blood transfusion, were also recorded. The RSI was calculated for all trauma patients and divided into two groups (RSI <1 and RSI ≥1). The t-test was performed with a 95% Confidence Interval (CI).
Results: Out of 363 patients, data from 320 patients were included. Among them, 55 patients (17.2%) had RSI <1, and 265 patients (82.8%) had RSI ≥1. Patients with RSI <1 exhibited lower GCS scores, tachypnoea (RR >29), or bradypnoea (RR <10), along with higher mortality rates. These patients also required resuscitative interventions. Those with RSI <1 experienced more head injuries, thoracic trauma, and maxillofacial injuries (p<0.001).
Conclusion: The RSI <1 in trauma patients demonstrated significantly higher predictive accuracy for adverse outcomes, serving as a primary tool for early intervention and aggressive care in the ER.
Emergency room, Mortality, Respiratory rate, Systolic blood pressure, Triage
DOI: 10.7860/JCDR/2024/67886.19384
Date of Submission: Oct 05, 2023
Date of Peer Review: Dec 18, 2023
Date of Acceptance: Mar 06, 2024
Date of Publishing: May 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? No
• For any images presented appropriate consent has been obtained from the subjects. NA
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• Plagiarism X-checker: Oct 06, 2023
• Manual Googling: Mar 01, 2024
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ETYMOLOGY: Author Origin
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