Shock Index and Injury Severity Score: Predictors of Mortality after Multi-System Trauma

Monday, 30 July 2012: 11:35 AM

Kathryn Moore, DNP, RN
College of Nursing, University of Kentucky, Lexington, KY

Learning Objective 1: The learner will be able to explain the three scoring systems used in trauma care and their application to trauma outcomes.

Learning Objective 2: The learner will be able to describe the usefulness of shock index as a trige tool for decision making at the scene of injury.

Purpose: The purpose of this study was to compare calculated shock index in the field and the Emergency Department with the calculated injury severity scores in their ability to predict death from trauma within 48 hours of sustaining traumatic injuries. In trauma, injury severity scoring is a process that reduces complex and variable patient data collected over varying periods of time to a single number. Patient triage decisions are based on the calculated score.

Methods: This study was a secondary analysis of baseline data from the 2009 National Trauma Data Base. The data were analyzed for descriptive information and logistic regression was applied to evaluate the predictive ability of the variables of interest.

Results: In a combined model, Emergency Department (ED) shock index was the strongest predictor of death within 48 hours of admission to the hospital after traumatic injuries. For each unit increase in calculated ED shock index in the combined model, the odds of death within 48 hours of traumatic injury increased by seventeen percent.

Conclusion: Shock index could be a useful addition to the toolbox available to both Emergency Medical Services providers and ED providers in making rapid decisions about critically injured patients with little information available.