Investigation of the Function of Modified Shock Index in the Disease Assessment of Emergency Cases_West China Medical Journal

Authors：

 XULing-jie ¹ , XUJun ² ,  WANGZhong ³

1. Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Emergency Department, Peking Union Medical College Hospital, Beijing 100032, P. R. China;
3. Beijing Tsinghua Changgung Hospital, Beijing 102218, P. R. China;

Corresponding?author：

WANGZhong, Email: wangzhong523@vip.163.com

Keywords：

Vital sign; Mean arterial pressure; Modified shock index; Emergency triage; Condition judgment

DOI：

10.7507/1002-0179.20150296

Video：

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Objective To research on the correlation between modified shock index (MSI), traditional vital sign assessment indexes and the proportion of patients entering resuscitation room through emergency triage, and to discuss its significance and advantages for emergency triage. Method A total of 22 153 emergency patients between January 1 and May 31, 2009 were retrospectively analyzed. We counted the shock index (SI), mean arterial pressure (MAP), MSI, and evaluated the reference range of MSI, based on which, the patients were divided into groups, and the proportion of patients entering resuscitation room in each group was compared. Based on pulse, systolic blood pressure (SBP), SI, MAP and MSI, the patients were again grouped for comparing the proportion of patients entering resuscitation room, and the positive predictive value, negative predictive value, and odds ratio (OR) were also analyzed. Results Reference value of MSI ranged from 0.34 to 1.70 times/(min·mm Hg) (1 mm Hg=0.133 kPa). Positive predictive values:MSI (16.239%) >MAP (6.115%) >pulse (5.746%) >SBP (5.321%) >SI (3.689%). The negative predictive values were all at high levels and similar with each other. OR:MSI (6.138) >MAP (2.498) >pulse (2.431) >SBP (2.117) >SI (1.361). Conclusions Pulse, SBP, SI, MAP, and MSI are correlated with the proportion of patients entering resuscitation room, and can be regarded as guide for emergency triage, among which MSI may be superior to all other indexes.

Citation： XULing-jie, XUJun, WANGZhong. Investigation of the Function of Modified Shock Index in the Disease Assessment of Emergency Cases. West China Medical Journal, 2015, 30(6): 1031-1034. doi: 10.7507/1002-0179.20150296 Copy

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11.	麥泉云, 趙開亮, 張鳳蓮, 等. 改良早期預警評分結合心電圖、休克指數、血氧飽和度對評估急診患者病情危重程度的價值[J]. 廣西醫學, 2012, 34(10):1305-1308.
12.	Vassallo J, Horne S, Ball S, et al. Usefulness of the shock index as a secondary triage tool[J]. J R Army Med Corps, 2015, 161(1):53-57.
13.	項濤. 休克指數對急性危重病人預后的判斷價值[J]. 四川省衛生管理干部學院學報, 2006, 25(3):208.
14.	溫勇偉, 鄔真力, 吳雷, 等. 超聲心動圖與休克指數在評價肺栓塞預后中的意義[J]. 廣東醫學, 2009, 30(4):578-580.
15.	余愿, 付朝暉, 徐夢, 等. 休克指數對感染性休克患者預后的預測價值[J]. 臨床急診雜志, 2014, 15(9):535-537.
16.	Mccall SJ, Musgrave SD, Potter JF, et al. The shock index predicts acute mortality outcomes in stroke[J]. Int J Cardiol, 2015, 182:523-527.
17.	陳煒, 臧學峰, 牛素平, 等. 監測液體復蘇前后血流動力學參數對膿毒性休克短期預后的早期預測價值[J]. 中華危重病急救醫學, 2015, 27(1):43-47.
18.	King RW, Plewa MC, Buderer NM, et al. Shock index as a marker for significant injury in trauma patients[J]. Acad Emerg Med, 1996, 3(11):1041-1045.

1. 趙麗新. 急診分診快速評分對老年患者病情評價[J]. 中國醫藥導報, 2011, 8(9):118-119.
2. 齊志偉, 劉業成, 徐軍, 等. 急診患者死亡危險因素分析[J]. 中國全科醫學, 2011, 14(14):1608-1609.
3. 譚慧瓊, 朱俊, 宋有城, 等. 急性左心衰竭并休克病人動脈內血壓監測指導血管活性藥物應用[J]. 中國循環雜志, 2001, 16(4):265-266.
4. 張光華. 特利加壓素與去甲腎上腺素對≥80歲感染性休克患者平均動脈壓及休克指數的影響[J]. 臨床和實驗醫學雜志, 2014, 13(16):1346-1348, 1349.
5. D'aragon F, Belley-Cote EP, Meade MO, et al. Blood pressure targets for vasopressor therapy:a systematic review[J]. Shock, 2015, 43(6):530-539.
6. Guyette FX, Meier EN, Newgard C, et al. A comparison of prehospital lactate and systolic blood pressure for predicting the need for resuscitative care in trauma transported by ground[J].J Trauma Acute Care Surg, 2015, 78(3):600-606.
7. Cannon CM, Braxton CC, Kling-Smith K, et al. Utility of the shock index in predicting mortality in traumatically injured patients[J]. J Trauma, 2009, 67(6):1426-1430.
8. Birkhahn RH, Gaeta TJ, Van Deusen SK, et al. The ability of traditional vital signs and shock index to identify ruptured ectopic pregnancy[J]. Am J Obstet Gynecol, 2003, 189(5):1293-1296.
9. Birkhahn RH, Gaeta TJ, Terry D, et al. Shock index in diagnosing early acute hypovolemia[J]. Am J Emerg Med, 2005, 23(3):323-326.
10. Jones AE, Trzeciak S, Kline JA. The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation[J]. Crit Care Med, 2009, 37(5):1649-1654.
11. 麥泉云, 趙開亮, 張鳳蓮, 等. 改良早期預警評分結合心電圖、休克指數、血氧飽和度對評估急診患者病情危重程度的價值[J]. 廣西醫學, 2012, 34(10):1305-1308.
12. Vassallo J, Horne S, Ball S, et al. Usefulness of the shock index as a secondary triage tool[J]. J R Army Med Corps, 2015, 161(1):53-57.
13. 項濤. 休克指數對急性危重病人預后的判斷價值[J]. 四川省衛生管理干部學院學報, 2006, 25(3):208.
14. 溫勇偉, 鄔真力, 吳雷, 等. 超聲心動圖與休克指數在評價肺栓塞預后中的意義[J]. 廣東醫學, 2009, 30(4):578-580.
15. 余愿, 付朝暉, 徐夢, 等. 休克指數對感染性休克患者預后的預測價值[J]. 臨床急診雜志, 2014, 15(9):535-537.
16. Mccall SJ, Musgrave SD, Potter JF, et al. The shock index predicts acute mortality outcomes in stroke[J]. Int J Cardiol, 2015, 182:523-527.
17. 陳煒, 臧學峰, 牛素平, 等. 監測液體復蘇前后血流動力學參數對膿毒性休克短期預后的早期預測價值[J]. 中華危重病急救醫學, 2015, 27(1):43-47.
18. King RW, Plewa MC, Buderer NM, et al. Shock index as a marker for significant injury in trauma patients[J]. Acad Emerg Med, 1996, 3(11):1041-1045.

West China Medical Journal

Investigation of the Function of Modified Shock Index in the Disease Assessment of Emergency Cases

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