The Predictive Value of Prehospital Simple Shock Index for Hypoperfusion in Trauma Patients

Trauma ranks as a leading cause of death among individuals under the age of 40 globally, with 30% to 40% of these fatalities resulting from excessive hemorrhage. This study aims to evaluate the predictive value of simple shock index (sSI) for detecting hypoperfusion in trauma patients in prehospital contexts.

This retrospective study included a total of 303 prehospital trauma patients from January 2020 to August 2023, comprising 191 males and 112 females. The patients were categorized into a hypoperfusion group and a nonhypoperfusion group based on the presence of shock during their stay in the resuscitation room. We further compared the two groups in terms of age, gender, prehospital fluid administration, prehospital transport duration, response time in prehospital care, shock index (SI), sSI and their correlation with hypoperfusion.

The nonparametric test for two independent samples (Mann-Whitney U test) revealed that age, SI, and sSI hold predictive value for hypoperfusion in prehospital trauma patients. The area under the receiver operating characteristic curve (AUC) illustrated their predictive sensitivity and specificity. The AUC for the SI was 0.819 (95% confidence interval: 0.769-0.868), with a sensitivity of 77.70% and specificity of 84.2%. For the sSI, the AUC was 0.817 (95% confidence interval: 0.767-0.866), with a sensitivity of 77.70% and specificity of 83.20%, demonstrating a statistically significant difference in predictive value compared to age.

Both the SI and the sSI effectively predict hypoperfusion in prehospital trauma patients. However, the sSI offers a more straightforward calculation, making it particularly suitable for assessing the condition of trauma patients in prehospital settings.