院前休克、改良休克、年龄调整休克指标和一些评分系统是否能有效预测高能创伤患者的预后？

IF 1.8 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2025-09-17 DOI:10.1016/j.ienj.2025.101678

Melih Yüksel, Mehmet Oğuzhan Ay, Fatma Betül Çalışkan, Ayşe Kılıç, Mustafa Tolga Özdal, Atakan Aydoğan, Yeşim İşler, Halil Kaya

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引用次数: 0

摘要

背景：本研究旨在探讨院前休克指数（SI）、修正休克指数（MSI）、年龄调整休克指数（ASI）、快速急诊医学评分（REMS）和急诊科预警评分（TREWS）是否能有效预测高能创伤患者的换血需求、紧急手术干预以及前24小时和28天死亡率。方法：对2023年8月1日至2024年1月31日期间因高能创伤被救护车送往单中心三级急诊的患者进行前瞻性分析。结果：共纳入209例符合研究标准的患者。在估计急诊科血液替代时，MSI的曲线下面积（AUC）值为0.789 (p)。结论：在高能创伤患者中，院前SI和MSI在预测急诊科血液替代和紧急手术干预方面均表现最佳。我们发现院前TREWS在预测前24 h和28 d的死亡率方面表现最好。

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“Are prehospital shock, modified shock, age-adjusted shock indices and some scoring systems effective in predicting the prognosis of high-energy trauma Patients?”

Background

This study aims to investigate whether prehospital shock index (SI), modified shock index (MSI), age-adjusted shock index (ASI), Rapid Emergency Medicine Score (REMS), and Triage in Emergency Department Early Warning Score (TREWS) are effective in predicting the need for blood replacement, emergency surgical intervention, and first 24 h and 28 days mortality in high-energy trauma patients.

Methods

Patients brought to a single-center, tertiary care emergency department by ambulance due to high-energy trauma between 01.08.2023 and 31.01.2024 were prospectively analyzed.

Results

A total of 209 patients meeting the study criteria were included. In blood replacement estimation in the emergency department, the area under the curve (AUC) value of MSI was found to be 0.789 (p < 0.001), SI was 0.783 (p < 0.001), and ASI was 0.688 (p = 0.016). For the prediction of emergency surgical intervention, the AUC value of SI was 0.784 (p < 0.001), MSI was 0.760 (p < 0.001) and TREWS was 0.641 (p = 0.043). As for the first 24 h mortality prediction, the AUC value of ASI was 0.872 (p < 0.001), MSI was 0.768 (p = 0.007), TREWS was 0.980 (p < 0.001), and REMS was 0.831 (p = 0.001). Finally, in the first 28-day mortality prediction, the AUC value of ASI was 0.759 (p = 0.001), TREWS was 0.942 (p < 0.001), and REMS was 0.826 (p < 0.001).

Conclusions

In high-energy trauma patients, prehospital SI and MSI indicated the best performance in predicting both blood replacement in the emergency department and emergency surgical intervention. We found that the prehospital TREWS showed the best performance in predicting mortality in the first 24 h and 28 days.

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来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.