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Related Concept Videos

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Related Experiment Video

Updated: Jun 14, 2025

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The Age-Modified Shock Index: Predicting Massive Transfusion and Mortality in Traumatic Injury Patients.

Soo Bin Choi1, Suck Ju Cho1, Seok-Ran Yeom1

  • 1Department of Emergency Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

Emergency Medicine International
|June 12, 2025
PubMed
Summary

The age-modified shock index (AMSI) was evaluated for predicting outcomes in trauma patients. While AMSI showed some predictive ability, it was not superior to other shock indices for massive transfusion or 24-hour mortality.

Keywords:
age shock indexinjurymassive transfusionshock index

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Area of Science:

  • Trauma care
  • Emergency medicine
  • Clinical prediction models

Background:

  • Shock index (SI), age-adjusted shock index (ASI), and modified shock index (MSI) are established predictors of outcomes in trauma.
  • The age-modified shock index (AMSI) has not been previously evaluated for prognostic value in traumatic injuries.

Purpose of the Study:

  • To assess the predictive performance of AMSI for massive transfusion (MT) and mortality in trauma patients.
  • To compare AMSI's predictive power against SI, ASI, and MSI.

Main Methods:

  • Retrospective, single-center study of 6591 trauma patients (January 2016 - December 2022).
  • Receiver operating characteristic (ROC) analysis was used to evaluate AMSI, SI, ASI, and MSI for predicting MT, in-hospital mortality, and 24-hour mortality.
  • Area under the ROC curve (AUROC) values were compared.

Main Results:

  • AMSI demonstrated predictive performance for MT (AUC > 0.7) and mortality (in-hospital AUC: 0.62, 24-hour AUC: 0.56).
  • AMSI did not outperform SI, ASI, or MSI in predicting MT or 24-hour mortality.
  • AMSI showed significantly better prediction for in-hospital mortality compared to other indices, though the difference from ASI was minor.

Conclusions:

  • AMSI is not superior to existing shock indices for predicting massive transfusion or 24-hour mortality in trauma patients.
  • Easier-to-compute indices may offer comparable or greater utility for prognostic evaluation in trauma.
  • Age significantly influences in-hospital mortality prediction.