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Review article: shock index for prediction of critical bleeding post-trauma: a systematic review.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Olaussen, Alexander Blackburn, Todd Mitra, Biswadev Fitzgerald, Mark
Description	Country affiliation: Australia Author Affiliation: Olaussen A ( Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia)
Abstract	Early diagnosis of haemorrhagic shock (HS) might be difficult because of compensatory mechanisms. Clinical scoring systems aimed at predicting transfusion needs might assist in early identification of patients with HS. The Shock Index (SI) - defined as heart rate divided by systolic BP - has been proposed as a simple tool to identify patients with HS. This systematic review discusses the SI's utility post-trauma in predicting critical bleeding (CB). We searched the databases MEDLINE, Embase, CINAHL, Cochrane Library, Scopus and PubMed from their commencement to 1 September 2013. Studies that described an association with SI and CB, defined as at least 4 units of packed red blood cells (pRBC) or whole blood within 24 h, were included. Of the 351 located articles identified by the initial search strategy, five met inclusion criteria. One study pertained to the pre-hospital setting, one to the military, two to the in-hospital setting, and one included analysis of both pre-hospital and in-hospital values. The majority of papers assessed predictive properties of the SI in ≥10 units pRBC in the first 24 h. The most frequently suggested optimal SI cut-off was ≥0.9. An association between higher SI and bleeding was demonstrated in all studies. The SI is a readily available tool and may be useful in predicting CB on arrival to hospital. The evaluation of improved utility of the SI by performing and recording at earlier time-points, including the pre-hospital phase, is indicated.
File Format	HTM / HTML
ISSN	17426731
Issue Number	3
Volume Number	26
e-ISSN	17426723
Journal	Emergency Medicine Australasia
Language	English
Publisher	Wiley-Blackwell
Publisher Date	2014-06-01
Publisher Place	Australia
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Medicine Severity Of Illness Index Shock, Hemorrhagic Diagnosis Wounds And Injuries Complications Adult Blood Pressure Physiology Female Heart Rate Humans Male Predictive Value Of Tests Reference Values Sensitivity And Specificity Physiopathology Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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