Shock indices as predictors in blunt trauma patients in the emergency department

To evaluate the effectiveness of Shock Index (SI), Modified Shock Index (MSI), and Age Shock Index (Age SI) in predicting blood transfusion need, surgical intervention, hospital outcomes, and injury severity in blunt trauma patients.

This retrospective study included 267 adult patients admitted with blunt trauma to the emergency department of a tertiary university hospital between 1 December 2018, and 1 December 2019. Patients with isolated hand/foot trauma, isolated traumatic brain injury, isolated spinal injuries, or minor trauma (AIS ≤2) were excluded. SI, MSI, and Age SI were calculated and analyzed.

SI (p < 0.001), Age SI (p = 0.001), and MSI (p < 0.001) were significantly associated with blood transfusion and mortality. SI > 0.933 and MSI > 1.159 showed good predictive accuracy for blood transfusion; Age SI > 30.945 showed moderate accuracy. For mortality, SI > 1.015, MSI > 1.333, and Age SI > 67.065 demonstrated good predictive power (all p < 0.001). SI and MSI correlated moderately with injury severity (p < 0.001), with SI > 0.905 and MSI > 1.181 indicating significant predictive value.

SI, MSI, and Age SI can predict early blood transfusion and mortality in blunt trauma patients. SI and MSI appear more reliable than Age SI, particularly in predicting transfusion need and injury severity.