Validation of the Shock Index, Modified Shock Index, and Age Shock Index for Predicting Mortality of Geriatric Trauma Patients in Emergency Departments.
The shock index (SI), modified shock index (MSI), and age multiplied by SI (Age SI) are used to assess the severity and predict the mortality of trauma patients, but their validity for geriatric patients is controversial. The purpose of this investigation was to assess predictive value of the SI, MSI, and Age SI for geriatric trauma patients. We used the Emergency Department-based Injury In-depth Surveillance (EDIIS), which has data from 20 EDs across Korea. Patients older than 65 years who had traumatic injuries from January 2008 to December 2013 were enrolled. We compared in-hospital and ED mortality of groups categorized as stable and unstable according to indexes. We also assessed their predictive power of each index by calculating the area under the each receiver operating characteristic (AUROC) curve. A total of 45,880 cases were included. The percentage of cases classified as unstable was greater among non-survivors than survivors for the SI (36.6% vs. 1.8%, P < 0.001), the MSI (38.6% vs. 2.2%, P < 0.001), and the Age SI (69.4% vs. 21.3%, P < 0.001). Non-survivors had higher median values than survivors on the SI (0.84 vs. 0.57, P < 0.001), MSI (0.79 vs. 1.14, P < 0.001), and Age SI (64.0 vs. 41.5, P < 0.001). The predictive power of the Age SI for in-hospital mortality was higher than SI (AUROC: 0.740 vs. 0.674, P < 0.001) or MSI (0.682, P < 0.001) in geriatric trauma patients.
Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, Korea.
Soon Yong
http://orcid.org/0000-0002-1685-812X
SY
Kim
Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea. emkjhong@gmail.com.|Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Ki Jeong
http://orcid.org/0000-0003-3334-817X
KJ
Hong
Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, Korea.|Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Sang Do
http://orcid.org/0000-0003-4953-2916
SD
Shin
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Young Sun
http://orcid.org/0000-0003-3634-9573
YS
Ro
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Ki Ok
http://orcid.org/0000-0002-8446-3269
KO
Ahn
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.|Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Yu Jin
http://orcid.org/0000-0001-7449-9025
YJ
Kim
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.|Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Eui Jung
http://orcid.org/0000-0001-8065-2014
EJ
Lee
D000368:Aged; D019540:Area Under Curve; D001794:Blood Pressure; D004636:Emergency Service, Hospital; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012372:ROC Curve; D012189:Retrospective Studies; D012769:Shock / Q000401:mortality* / Q000473:pathology
Emergency Medical Services; Geriatrics; Shock; Trauma