{"title":"逆休克指数乘以简化运动评分作为急诊科腹部创伤患者临床结局的指标：一项回顾性队列研究","authors":"Ilker Şirin, Tuğba Sanalp Menekşe, Muzaffer Akkoca","doi":"10.14744/tjtes.2025.23798","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the diagnostic value of the product of the reverse Shock Index (rSI) and the simplified Motor Score (sMS) (rSIsMS) as a predictor of clinical outcomes in patients with abdominal trauma.</p><p><strong>Methods: </strong>Patients who presented with abdominal trauma to the emergency department of a tertiary care hospital between 2023 and 2024 were included in the study. Using the patients' data, we calculated the Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS). Additionally, the rSIsMS and the product of the rSI and Glasgow Coma Scale (GCS) (rSIG) were calculated.</p><p><strong>Results: </strong>A total of 270 patients were included in the study. The diagnostic validity of the TRISS, rSIsMS, and rSIG, which had the highest area under the curve (AUC) values for mortality outcomes, was examined; the AUC values were 0.928, 0.908, and 0.886, respectively. The AUC values of the TRISS and rSIsMS concerning intensive care unit (ICU) needs were 0.844 and 0.852, respectively. With regard to surgical intervention needs, the AUC values of the TRISS and rSIsMS were 0.774 and 0.881, respectively. The diagnostic validity of the rSIsMS for surgical intervention needs was significantly higher than that of the TRISS (p<0.001, DeLong test). Concerning massive transfusion protocol (MTP) requirements, the AUC values of the TRISS and rSIsMS were 0.799 and 0.930, respectively. The diagnostic validity of the rSIsMS for MTP requirements was significantly higher than that of the TRISS (p<0.001, DeLong test).</p><p><strong>Conclusion: </strong>The rSIsMS is superior to other trauma scores in predicting MTP and surgical intervention needs in patients with abdominal trauma, and it performs similarly to other trauma scores in predicting mortality and ICU needs. The ease of calculation and its ability to be obtained at the bedside may further enhance the clinical utility of the rSIsMS in the emergency department.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 4","pages":"332-340"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000983/pdf/","citationCount":"0","resultStr":"{\"title\":\"Reverse shock index multiplied by simplified motor score as an indicator of clinical outcomes in patients with abdominal trauma in the emergency department: a retrospective cohort study.\",\"authors\":\"Ilker Şirin, Tuğba Sanalp Menekşe, Muzaffer Akkoca\",\"doi\":\"10.14744/tjtes.2025.23798\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to determine the diagnostic value of the product of the reverse Shock Index (rSI) and the simplified Motor Score (sMS) (rSIsMS) as a predictor of clinical outcomes in patients with abdominal trauma.</p><p><strong>Methods: </strong>Patients who presented with abdominal trauma to the emergency department of a tertiary care hospital between 2023 and 2024 were included in the study. Using the patients' data, we calculated the Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS). Additionally, the rSIsMS and the product of the rSI and Glasgow Coma Scale (GCS) (rSIG) were calculated.</p><p><strong>Results: </strong>A total of 270 patients were included in the study. The diagnostic validity of the TRISS, rSIsMS, and rSIG, which had the highest area under the curve (AUC) values for mortality outcomes, was examined; the AUC values were 0.928, 0.908, and 0.886, respectively. The AUC values of the TRISS and rSIsMS concerning intensive care unit (ICU) needs were 0.844 and 0.852, respectively. With regard to surgical intervention needs, the AUC values of the TRISS and rSIsMS were 0.774 and 0.881, respectively. The diagnostic validity of the rSIsMS for surgical intervention needs was significantly higher than that of the TRISS (p<0.001, DeLong test). Concerning massive transfusion protocol (MTP) requirements, the AUC values of the TRISS and rSIsMS were 0.799 and 0.930, respectively. The diagnostic validity of the rSIsMS for MTP requirements was significantly higher than that of the TRISS (p<0.001, DeLong test).</p><p><strong>Conclusion: </strong>The rSIsMS is superior to other trauma scores in predicting MTP and surgical intervention needs in patients with abdominal trauma, and it performs similarly to other trauma scores in predicting mortality and ICU needs. The ease of calculation and its ability to be obtained at the bedside may further enhance the clinical utility of the rSIsMS in the emergency department.</p>\",\"PeriodicalId\":94263,\"journal\":{\"name\":\"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES\",\"volume\":\"31 4\",\"pages\":\"332-340\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000983/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14744/tjtes.2025.23798\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14744/tjtes.2025.23798","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Reverse shock index multiplied by simplified motor score as an indicator of clinical outcomes in patients with abdominal trauma in the emergency department: a retrospective cohort study.
Background: This study aimed to determine the diagnostic value of the product of the reverse Shock Index (rSI) and the simplified Motor Score (sMS) (rSIsMS) as a predictor of clinical outcomes in patients with abdominal trauma.
Methods: Patients who presented with abdominal trauma to the emergency department of a tertiary care hospital between 2023 and 2024 were included in the study. Using the patients' data, we calculated the Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS). Additionally, the rSIsMS and the product of the rSI and Glasgow Coma Scale (GCS) (rSIG) were calculated.
Results: A total of 270 patients were included in the study. The diagnostic validity of the TRISS, rSIsMS, and rSIG, which had the highest area under the curve (AUC) values for mortality outcomes, was examined; the AUC values were 0.928, 0.908, and 0.886, respectively. The AUC values of the TRISS and rSIsMS concerning intensive care unit (ICU) needs were 0.844 and 0.852, respectively. With regard to surgical intervention needs, the AUC values of the TRISS and rSIsMS were 0.774 and 0.881, respectively. The diagnostic validity of the rSIsMS for surgical intervention needs was significantly higher than that of the TRISS (p<0.001, DeLong test). Concerning massive transfusion protocol (MTP) requirements, the AUC values of the TRISS and rSIsMS were 0.799 and 0.930, respectively. The diagnostic validity of the rSIsMS for MTP requirements was significantly higher than that of the TRISS (p<0.001, DeLong test).
Conclusion: The rSIsMS is superior to other trauma scores in predicting MTP and surgical intervention needs in patients with abdominal trauma, and it performs similarly to other trauma scores in predicting mortality and ICU needs. The ease of calculation and its ability to be obtained at the bedside may further enhance the clinical utility of the rSIsMS in the emergency department.
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