Jinxia Yan#, Weixing Ge#, Bo Liao*
Department of critical medicine, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu211100, China
Objective: To investigate the prognostic value of dynamic monitoring 24-hour rSIG (The reverse shock index multiplied by Glasgow Coma scale score rSIG) and rSIG/A (rSIG/Age) score in patients with multiple trauma during hospitalization.
Methods: We retrospectively collected clinical data of multiple trauma patients who were admitted to the Intensive Care Unit (ICU) of Nanjing Jiangning Hospital from January 2013 to December 2020. We divided patients into death and survival groups and compared general information and clinical characteristics between the two groups, including injury severity score (ISS), injury site, underlying diseases, 24-hour heart rate, blood pressure, rSIG and rSIG /A score, etc.; We plotted the receiver operating characteristic curve (ROC curve) and calculated the area under curve (AUC) to evaluate the prognostic value of rSIG and rSIG/A index in patients with multiple trauma.
Results: A total of 405 patients with multiple trauma were included, including 86 in the death group and 319 in the survival group. The ISS, average heart rate 12-24 hours after admission, and average heart rate 0-24 hours after admission in the survival group were significantly lower than those in the death group [24(17-30) vs 30(23-37.25), 75.76±18.18 bpm vs 82.56±18.87 bpm, 77.94±20.69 bpm vs 83.56±21.97 bpm, p<0.01]. Baseline systolic blood pressure (SBP), 12-24h SBP, baseline diastolic blood pressure (DBP), 12-24h DBP, GCS score, and 12-24h rSIG and 12-24h rSIG/A were significantly higher in the survival group than in death group (p<0.05). Logistic regression analysis showed that 12-24-hour rSIG (95% CI: 0.910-0.960, p<0.01) and 12-24-hour rSIG/A (95% CI: 0.886-0.942, p<0.01) were independent risk factors for the prognosis of multiple trauma. The ROC curve showed that the AUC of 12-24-hour rSIG and 12-24-hour rSIG/A for predicting multiple trauma death was 0.938 and 0.928, respectively.
Conclusion: 12-24-hour rSIG and 12-24-hour rSIG/A are independent risk factors for death in patients with multiple trauma. They have good predictive value for prognosis in patients with multiple trauma and may help the early detection of patients with high risk of death.
Multiple trauma, the reverse shock index multiplied by Glasgow coma scale score, rSIG/A, prognosis.