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Predictive Value of Prehospital Point-of-Care Glucose Measurement and Shock Indices in Traumatically Injured Patients: A Retrospective Study.

Joseph Hill, Jeremy Norman, M David Gothard, Michelle M McLean, Deanne Krajkowski, Bethany Figg, Jeff Marr

Air Medical Journal · 2025-01-01 · Observational study

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Abstract

OBJECTIVE: Stress-induced hyperglycemia is a well-established risk factor for mortality in critically ill trauma patients. Limited research exists on prehospital diagnostic tools for predicting hemorrhagic shock and mortality in this population. METHODS: A retrospective study involving 435 adult and pediatric trauma patients transported by air ambulance in 13 years aimed to assess the predictive value of prehospital point-of-care glucose (POCG), shock index (SI), Glasgow Coma Scale (GCS), fluid administration, and reverse SI multiplied by GCS (rSIG) for 24-hour and 30-day mortalities. RESULTS: Univariate analyses revealed that an elevated SI and lower GCS were associated with increased mortality, whereas POCG and crystalloid fluid administration were not significant predictors. Multivariate analysis confirmed SI and GCS as independent predictors of 30-day mortality. The rSIG emerged as the strongest predictor, with an Area Under the Receiver Operating Characteristic curve (AUROC) of 0.872. POCG alone did not demonstrate statistical significance in predicting mortality. CONCLUSION: Prehospital SI and GCS are valuable predictors of mortality, with rSIG offering the highest predictive accuracy. Despite limitations, this study suggests the potential impact of prehospital markers on trauma-related outcomes, emphasizing the need for further research validation.

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Tags

Helicopter & air ambulance · Early warning scores · Mortality & survival · Point-of-care tests

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