Shock index as a predictor for short-term mortality in helicopter emergency medical services : A registry study

Show full item record



Permalink

http://hdl.handle.net/10138/341374

Citation

Björkman , J , Raatiniemi , L , Setälä , P & Nurmi , J 2021 , ' Shock index as a predictor for short-term mortality in helicopter emergency medical services : A registry study ' , Acta Anaesthesiologica Scandinavica , vol. 65 , no. 6 , pp. 816-823 . https://doi.org/10.1111/aas.13765

Title: Shock index as a predictor for short-term mortality in helicopter emergency medical services : A registry study
Author: Björkman, Johannes; Raatiniemi, Lasse; Setälä, Piritta; Nurmi, Jouni
Contributor organization: Department of Diagnostics and Therapeutics
University of Helsinki
HUS Emergency Medicine and Services
Staff Services
Helsinki University Hospital Area
Date: 2021-07
Language: eng
Number of pages: 8
Belongs to series: Acta Anaesthesiologica Scandinavica
ISSN: 0001-5172
DOI: https://doi.org/10.1111/aas.13765
URI: http://hdl.handle.net/10138/341374
Abstract: Background The value of shock-index has been demonstrated in hospital triage, but few studies have evaluated its prehospital use. The aim of our study was to evaluate the association between shock-index in prehospital critical care and short-term mortality. Methods We analyzed data from the national helicopter emergency medical services database and the Population Register Centre. The shock-index was calculated from the patients' first measured parameters. The primary outcome measure was 1- and 30-day mortality. Results A total of 22 433 patients were included. The 1-day mortality was 7.5% and 30-day mortality was 16%. The median shock-index was 0.68 (0.55/0.84) for survivors and 0.67 (0.49/0.93) for non-survivors (P = .316) at 30-days. Association between shock-index and mortality followed a U-shaped curve in trauma (shock-index <0.5: odds ratio 2.5 [95% confidence interval 1.8-3.4], shock-index > 1.3: odds ratio 4.4 [2.7-7.2] at 30 days). Patients with neurological emergencies with a low shock-index had an increased risk of mortality (shock-index <0.5: odds ratio 1.8 [1.5-2.3]) whereas patients treated after successful resuscitation from out-of-hospital cardiac arrest, a higher shock-index was associated with higher mortality (shock-index > 1.3: odds ratio 3.5 [2.3-5.4). The association was similar for all ages, but older patients had higher mortality in each shock-index category. Conclusion The shock-index is associated with short time mortality in most critical patient categories in the prehospital setting. However, the marked overlap of shock-index in survivors and non-survivors in all patient categories limits its predictive value.
Subject: air ambulances
emergency medical services
mortality
shock
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: acceptedVersion


Files in this item

Total number of downloads: Loading...

Files Size Format View
Shock_index_as_ ... vices_a_registry_study.pdf 9.097Mb PDF View/Open

This item appears in the following Collection(s)

Show full item record