Asset Details
Do you wish to reserve the book?
Can the shock index be a reliable predictor of early mortality after trauma in older patients? A retrospective cohort study
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
Can the shock index be a reliable predictor of early mortality after trauma in older patients? A retrospective cohort study
Do you wish to request the book?
Can the shock index be a reliable predictor of early mortality after trauma in older patients? A retrospective cohort study
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
Can the shock index be a reliable predictor of early mortality after trauma in older patients? A retrospective cohort study
2019
Overview
Aim Older patients have different physiological characteristics; thus, the reliability of the shock index (SI) to predict mortality could depend on age. We investigated whether the SI is a reliable predictor of early mortality in older patients and evaluated the clinical benefit of age in the interpretation of the SI. Methods Using data from the Japan Trauma Data Bank, we identified injured patients aged 20–84 years. Area under the receiver operating characteristic curve (AUC) was used to evaluate the discrimination ability of the SI to predict early mortality. A formula to determine the cut‐off for each age was derived using linear regression analysis. Performance of the new method was compared with that of the traditional SI cut‐off of ≥0.9 AUC. Results We analyzed data from 146,802 patients. Early mortality was observed in 4% of patients. The AUC showed a significant negative correlation with age (Spearman's ρ = –0.97, P < 0.001), and it decreased from 0.788 (95% confidence interval [CI], 0.761–0.815) in the 20–24 years age group to 0.660 (95% CI, 0.643–0.676) in those aged 80–84 years. By adjusting for age in the SI interpretation, AUC significantly improved from 0.681 (95% CI, 0.675–0.688) to 0.695 (95% CI, 0.688–0.701) (P < 0.001). Conclusions The performance of the SI to predict mortality after trauma was significantly worse in older patients. Even if the SI cut‐off value was adjusted based on age, the decrease in performance was not sufficiently prevented. Our results indicated that clinicians should be cautious when using the SI in older patients. The reliability of the shock index as a predictor of early mortality largely depends on the age of patients. Clinicians should be cautious when using the shock index in older patients.
