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Review article: Shock Index for prediction of critical bleeding post‐trauma: A systematic review
Author(s) -
Olaussen Alexander,
Blackburn Todd,
Mitra Biswadev,
Fitzgerald Mark
Publication year - 2014
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12232
Subject(s) - medicine , packed red blood cells , cinahl , hemorrhagic shock , predictive value , medline , shock (circulatory) , emergency medicine , intensive care medicine , blood transfusion , psychological intervention , psychiatry , political science , law
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 S hock I ndex ( 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 , E mbase, CINAHL , C ochrane L ibrary, S copus and P ubMed from their commencement to 1 S eptember 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.