"Are prehospital shock, modified shock, age-adjusted shock indices and some scoring systems effective in predicting the prognosis of high-energy trauma Patients?".
International emergency nursing · 2025-09-17 · Observational study
Abstract
BACKGROUND: This study aims to investigate whether prehospital shock index (SI), modified shock index (MSI), age-adjusted shock index (ASI), Rapid Emergency Medicine Score (REMS), and Triage in Emergency Department Early Warning Score (TREWS) are effective in predicting the need for blood replacement, emergency surgical intervention, and first 24 h and 28 days mortality in high-energy trauma patients. METHODS: Patients brought to a single-center, tertiary care emergency department by ambulance due to high-energy trauma between 01.08.2023 and 31.01.2024 were prospectively analyzed. RESULTS: A total of 209 patients meeting the study criteria were included. In blood replacement estimation in the emergency department, the area under the curve (AUC) value of MSI was found to be 0.789 (p < 0.001), SI was 0.783 (p < 0.001), and ASI was 0.688 (p = 0.016). For the prediction of emergency surgical intervention, the AUC value of SI was 0.784 (p < 0.001), MSI was 0.760 (p < 0.001) and TREWS was 0.641 (p = 0.043). As for the first 24 h mortality prediction, the AUC value of ASI was 0.872 (p < 0.001), MSI was 0.768 (p = 0.007), TREWS was 0.980 (p < 0.001), and REMS was 0.831 (p = 0.001). Finally, in the first 28-day mortality prediction, the AUC value of ASI was 0.759 (p = 0.001), TREWS was 0.942 (p < 0.001), and REMS was 0.826 (p < 0.001). CONCLUSIONS: In high-energy trauma patients, prehospital SI and MSI indicated the best performance in predicting both blood replacement in the emergency department and emergency surgical intervention. We found that the prehospital TREWS showed the best performance in predicting mortality in the first 24 h and 28 days.
Tags
Early warning scores · Mortality & survival · Triage instruments