1. Modifying effects of alcohol use and age on the predictive performance of prehospital shock index for functional and survival outcomes in severe trauma patients
- Author
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Young Ju Cho, Yong Soo Cho, Eujene Jung, Byeong Jo Chun, Ho Goon Kim, and Hyun Yi Kook
- Subjects
shock index ,trauma ,alcohol ,Medicine (General) ,R5-920 - Abstract
This study investigated whether the prehospital shock index (SI) could predict clinical outcomes in trauma patients, with or without pre-injury alcohol consumption, and whether this predictive capacity varied by age. We conducted a retrospective study on severe trauma patients transported to a level-1 trauma center by emergency medical services from 2015 to 2021. Our primary exposure was abnormal SI, defined as an SI ≥0.9, with in-hospital mortality and poor functional outcomes as study outcomes of interest. Multivariable logistic regression analysis estimated the effect of SI on clinical outcomes. Our findings indicated a significant association between abnormal SI and poor functional outcomes in all trauma patients (adjusted odds ratio: 2.15; 95% confidence interval: 1.41–3.28), notably pronounced in the older age group (adjusted odds ratio: 3.56; 95% confidence interval: 1.55–8.30). However, no association was found with in-hospital mortality. Importantly, among severe trauma patients who did not consume alcohol, abnormal SI was significantly associated with poor functional outcomes, irrespective of age, and with increased in-hospital mortality exclusively in the older age group. Thus, abnormal SI significantly predicted clinical outcomes in non-alcohol-consuming severe trauma patients, with the predictive power for in-hospital mortality being specifically significant in older, non-alcohol-consuming patients.
- Published
- 2023
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