Relationship Between Shock Index and Pulse Pressure for Prognosis in Patients with Major Trauma

Determining the prognosis of trauma patients is crucial for prioritizing and triaging these patients. This study aimed to investigate the relationship between the shock index (SI) and pulse pressure (PP) with the prognosis of major trauma patients. In this cohort study, 300 patients aged 16 to 63 years with moderate to severe trauma who were referred to Madani Educational Center in Karaj, Iran, from April to October 2022, were selected using convenience sampling. The relationship between the SI and PP with patient outcomes, including the need for blood transfusion, intensive care unit (ICU) admission, urgent surgery, and in-hospital mortality, was analyzed using Pearson correlation coefficient and multivariate regression analysis at a 95% confidence level. Among the 300 participants, 206 (68.7%) were men, most (113, 37.7%) were aged 28 to 39 years, and 176 (58.7%) were referred after a vehicle accident. A total of 107 (35.7%) were admitted to the ICU, 74 required blood transfusion, 67 (22.3%) required emergency surgery, and 33 (11.0%) died in the hospital. There was a significant correlation between the SI and PP with poor prognosis (p < 0.001). Specifically, SI showed a positive correlation with the need for emergency surgery (r = 0.85), ICU admission (r = 0.90), blood transfusion (r = 0.92), and in-hospital mortality (r = 0.79). Conversely, high PP showed a negative correlation with ICU admission (r = - 0.55), blood transfusion (r = - 0.59), and in-hospital mortality (r = - 0.52). The SI and PP could be used as suitable tools for triage and prognosis of trauma patients.