The reverse shock index multiplied by Glasgow coma scale (rSIG) is predictive of mortality in trauma patients according to age

ABSTRACT

Objective

The role of reverse shock index multiplied Glasgow coma scale (rSIG) in patients post-trauma with traumatic brain injury (TBI) has not yet been defined well. Our study aimed to investigate the predictive performance of rSIG according to age group.

Method

This is a prospective multi-national and multi-center cohort study using Pan-Asian Trauma Outcome Study registry in Asian-Pacific, conducted on patients post-trauma who visited participating hospitals. The main exposure was low rSIG measured at emergency department. The main outcome was in-hospital mortality. We performed multilevel logistic regression analysis to estimate the association low rSIG and study outcomes. Interaction analysis between rSIG and age group were also conducted.

Results

Low rSIG was significantly associated with an increase in in-hospital mortality in patients post-trauma with and without TBI (aOR (95% CI): 1.49 (1.04–2.13) and 1.71 (1.16–2.53), respectively). The ORs for in-hospital mortality differed according to the age group in patients post-trauma with TBI (1.72 (1.44–1.94) for the young group and 1.13 (1.07–1.52) for the old group; p < 0.05).

Conclusion

Low rSIG is associated with an increase in in-hospital mortality in adult patients post-trauma. However, in patients with TBI, the prediction of mortality is significantly better in younger patient group.

KEYWORDS:

• Shock index
• trauma
• outcome

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

Dr. Ryu and Jung had full access to all of the data in the study and take responsibility for the integrity of the data as well as the accuracy of the data analysis.

Study concept and design: Ryu, Heo, and Jung

Acquisition, analysis, or interpretation of data: Ryu and Jung

Drafting of the manuscript: Ryu, Heo, and Jung

Critical revision of the manuscript for important intellectual content: Ryu and Jung

Statistical analysis: Ryu, Heo, and Jung

Obtained funding: Ryu, Heo, and Jung

Administrative, technical or material support: Ryu and Jung

Study supervision: Ryu

Manuscript approval: All authors.

Additional information

Funding

This study was supported by a grant (BCRI-20022) from Chonnam National University Hospital Biomedical Research Institute.