Background
Pediatric trauma has a significant effect on childhood mortality. Shock index (SI) is a physiological score that evaluates trauma severity and also predicts early shock. Few studies exist in the literature regarding the use of the SI on defining the severity of trauma mortality. This study aimed to evaluate the performance of SI for prediction of trauma-related mortality in pediatric population.
Patients and methods
A prospective study was conducted that included 200 patients with polytrauma aged less than 16 years admitted to Emergency University Hospitals within 24 h of trauma from January 2019 till January 2021. SI was evaluated for all patients regarding receiver operating characteristic curve, sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and cutoff points for prediction of mortality.
Results
SI was superior to injury severity score in prediction of mortality. A cutoff more than or equal to 0.9 of SI to predict mortality has a sensitivity of 97.62% and a specificity of 85.71, and a cutoff more than or equal to 21 of injury severity score has a sensitivity of 75% and a specificity of 80.95%. Higher SI was associated with a higher rate of death.
Conclusions
SI is a reliable predictor of mortality but needs to be investigated in detail. It is an applicable easy method for predicting mortality in pediatric emergency. This would evaluate early invasive monitoring and decision of ideal treatment in an ICU.