Reverse shock index multiplied by Glasgow coma scale (rSIG) to predict mortality in traumatic brain injury: systematic review and meta-analysis

Medicina intensiva Pub Date : 2025-09-01 DOI:10.1016/j.medine.2025.502149

Gustavo Adolfo Vásquez-Tirado , Edinson Dante Meregildo-Rodríguez , Claudia Vanessa Quispe-Castañeda , María Cuadra-Campos , Wilson Marcial Guzmán-Aguilar , Percy Hernán Abanto-Montalván , Hugo Alva-Guarniz , Leslie Jacqueline Liñán-Díaz , Luis Ángel Rodríguez-Chávez

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Abstract

Objective

To determine whether the Reverse Shock Index multiplied by the Glasgow Coma Scale (rSIG) is a predictor of in-hospital mortality in patients with traumatic brain injury (TBI).

Design

This is a systematic review and meta-analysis.

Setting

A comprehensive search was conducted in five databases for studies published up to May 22, 2024, using a PECO strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis.

Participants

The participants of the included primary studies.

Interventions

Patients with a low rSIG as a predictor of in-hospital mortality in TBI.

Main variables of interest

rSIG, in-hospital mortality, TBI.

Results

Our meta-analysis evaluated a total of eight observational studies encompassing 430,000 patients with TBI, observing 6,417 deaths (15%). After performing a sensitivity analysis, we found that patients with TBI and a low value of the reverse shock index multiplied by the Glasgow Coma Scale (rSIG) had a 24% higher risk of death (OR 1.24; 95% CI 1.12–1.38; I²: 96%). Furthermore, rSIG values were significantly higher in survivors compared to those who died (MD 7.72; 95% CI 1.86–13.58; I²: 99%).

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逆休克指数乘以格拉斯哥昏迷量表（rSIG）预测外伤性脑损伤死亡率：系统回顾和荟萃分析

目的：确定逆休克指数乘以格拉斯哥昏迷量表（rSIG）是否可以预测外伤性脑损伤（TBI）患者的住院死亡率。设计：这是一项系统回顾和荟萃分析。设置：使用PECO策略，在五个数据库中对截至2024年5月22日发表的研究进行了全面检索。8项研究被确定用于定量分析，并纳入我们的荟萃分析。参与者：纳入的主要研究的参与者。干预措施：低rSIG患者作为TBI住院死亡率的预测因子。主要感兴趣的变量：rSIG，住院死亡率，TBI。结果：我们的荟萃分析共评估了8项观察性研究，包括430,000例TBI患者，观察到6,417例死亡（15%）。在进行敏感性分析后，我们发现，与格拉斯哥昏迷量表（rSIG）相比，逆行休克指数较低的TBI患者的死亡风险高出24% (OR 1.24；95% ci 1.12-1.38；我²:96%)。此外，幸存者的rSIG值明显高于死亡患者(MD 7.72；95% ci 1.86-13.58；我²:99%)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medicina intensiva

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