Ulus Travma Acil Cerrahi Derg. 2023; 29(7): 786-791 | DOI: 10.14744/tjtes.2023.29677

The effectiveness of shock indices on prognosis in burn patients admitted to the emergency department

Mustafa Ýçer¹, Ercan Gündüz¹, Mehmet Fatih Akkoç², Dicle Polat¹, Halime Özkan¹, Tuðçe Bayrak¹, Þilan Göger^1
1Department of Emergency Medicine, Dicle University Faculty of Medicine, Diyarbakýr-Türkiye
²Department of Plastic and Reconstructive Surgery, University Faculty of Medicine, Diyarbakýr-Türkiye

BACKGROUND: Shock index (SI) is the ratio of heart rate (HR) to systolic blood pressure (SBP); modified SI (MSI) is the ratio of HR to mean arterial pressure; age SI (ASI) is age multiplied by SI; reverse SI (rSI) is the ratio of SBP to HR; and rSIG is rSI multiplied by Glasgow Coma Scale Score (rSIG). Studies have proven that shock indices are good tools in predicting mortality. This study aimed to evaluate the sensitivity of the shock indices SI, MSI, ASI, rSI, and rSIG in predicting mortality in burn patients.
METHODS: This is a retrospective cross-sectional study. The vital signs of the patients were recorded and their shock indices were calculated at the time of emergency department admission. The effectiveness of the shock indices SI, MSI, ASI, rSI, and rSIG in predict-ing mortality was compared in the burn patients included in the study
RESULTS: A total of 913 patients were enrolled. rSIG and MSI were the shock indices with the highest area under the curve (AUC) values in predicting mortality in the burn patients. The AUC values of rSIG and MSI were 0.829 (95% CI: 0.739–0.919, P<0.001) and 0.740 (95% CI: 0.643–0.838, P<0.001), respectively.
CONCLUSION: Vital signs are easily recorded and shock indices are easily calculated at the time of admission of burn patients to the emergency department; they also effectively predict mortality. rSIG and MSI are the best mortality predictors among the shock indices examined in this study.

Keywords: Age shock index, burn; modified shock index; rSIG; shock index.

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Acil servise baþvuran yanýk hastalarýnda þok indekslerinin prognoz üzerine olan etkinliði

Mustafa Ýçer¹, Ercan Gündüz¹, Mehmet Fatih Akkoç², Dicle Polat¹, Halime Özkan¹, Tuðçe Bayrak¹, Þilan Göger^1
1Dicle Üniversitesi Týp Fakültesi, Acil Týp Anabilim Dalý, Diyarbakýr, Türkiye
²Dicle Üniversitesi Týp Fakültesi, Plastik ve Rekonstrüktif Cerrahi Anabilim Dalý, Diyarbakýr, Türkiye

AMAÇ: Þok indeksi (SI), nabýzýn (HR) sistolik kan basýncýna (SBP) oraný; modifiye þok indeksi (MSI), HR nin ortalama arter basýncýna oraný; yaþ þok indeksi (ASI), yaþýn SI ile çarpýmý; rivers þok indeksi (rSI), SBP nin HR ye oraný; rSIG, rSI nýn Glasgow Koma Skoru (GCS) ile çarpýmýdýr. Yapýlmýþ çalýþmalarda þok indekslerinin mortaliteyi öngörmede iyi araçlar olduðu kanýtlanmýþtýr. Bu çalýþmanýn amacý yanýk hastalarýnda SI, MSI, ASI, rSI, rSIG þok indekslerinin mortaliteyi öngörmedeki duyarlýlýðýný deðerlendirmektir.
GEREÇ VE YÖNTEM: Bu çalýþma retrospektif kesitsel bir çalýþmadýr. Hastalarýn acil servise baþvuru anýndaki vital bulgularý alýndý ve þok indeksleri hesaplandý. Çalýþmaya alýnan yanýk hastalarýnda SI, MSI, ASI, rSI, rSIG þok indekslerinin mortaliteyi öngörmedeki etkinliði karþýlaþtýrýldý. BULGULAR: Toplam 913 hasta çalýþmaya alýndý. Yanýk hastarýnda mortaliteyi öngörmede eðri altýnda kalan alan (AUC) deðeri en yüksek olan þok indeksleri rSIG ve MSI idi. Deðerleri sýrasýyla rSIG (AUC: 0.829, %95 CI: 0.739-0.919, p<0.001) ve MSI (AUC: 0.740, %95 CI: 0.643-0.838, p<0.001) idi.
TARTIÞMA: Yanýk hastalarýnýn acil servise baþvuru anýndaki vital bulgularý ile þok indekslerinin hesaplanmasý basittir ve mortaliteyi öngörmede etkilidirler. Çalýþmadaki þok indeksleri içinde mortaliteyi öngörmede en iyisi rSIG ve MSI’dýr.

Anahtar Kelimeler: Þok indeksi, modifiye þok indeksi; rSIG; yaþ þok indeksi; yanýk.

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