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

Research output: Contribution to journalArticleResearchpeer-review

58 Citations (Scopus)

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 24h, 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 24h. 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.
Original languageEnglish
Pages (from-to)223 - 228
Number of pages6
JournalEMA - Emergency Medicine Australasia
Volume26
Issue number3
DOIs
Publication statusPublished - 2014

Cite this

@article{8a228d591b2445038283ccca4b360ee3,
title = "Review article: shock index for prediction of critical bleeding post-trauma: a systematic review",
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 24h, 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 24h. 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.",
author = "Alexander Olaussen and Todd Blackburn and Biswadev Mitra and Mark Fitzgerald",
year = "2014",
doi = "10.1111/1742-6723.12232",
language = "English",
volume = "26",
pages = "223 -- 228",
journal = "EMA - Emergency Medicine Australasia",
issn = "1742-6731",
publisher = "Wiley-Blackwell",
number = "3",

}

Review article: shock index for prediction of critical bleeding post-trauma: a systematic review. / Olaussen, Alexander; Blackburn, Todd; Mitra, Biswadev; Fitzgerald, Mark.

In: EMA - Emergency Medicine Australasia, Vol. 26, No. 3, 2014, p. 223 - 228.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Review article: shock index for prediction of critical bleeding post-trauma: a systematic review

AU - Olaussen, Alexander

AU - Blackburn, Todd

AU - Mitra, Biswadev

AU - Fitzgerald, Mark

PY - 2014

Y1 - 2014

N2 - 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 24h, 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 24h. 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.

AB - 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 24h, 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 24h. 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.

UR - http://onlinelibrary.wiley.com/doi/10.1111/1742-6723.12232/pdf

U2 - 10.1111/1742-6723.12232

DO - 10.1111/1742-6723.12232

M3 - Article

VL - 26

SP - 223

EP - 228

JO - EMA - Emergency Medicine Australasia

JF - EMA - Emergency Medicine Australasia

SN - 1742-6731

IS - 3

ER -