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"Shock index"

Praveen Hariharan, David M Dudzinski, Rachel Rosovsky, Farris Haddad, Peter MacMahon, Blair Parry, Yuchiao Chang, Christopher Kabrhel
Computed tomography pulmonary angiogram (CTPA) provides a volumetric assessment of clot burden in acute pulmonary embolism (PE). However, it is unclear if clot burden is associated with right-sided heart strain (RHS) or adverse clinical events (ACE). We prospectively enrolled Emergency Department patients with PE (in CTPA) from 2008 to 2011. We assigned 1 to 9 points as clot burden score, based on whether emboli were saddle, central, lobar, segmental, and subsegmental. We evaluated a novel score (the "CT-PASS") based on the sum (in millimeters) of the largest filling defects in the right and left pulmonary vasculature...
August 24, 2016: American Journal of Cardiology
Sameer Mehta
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Maria E Linnaus, David M Notrica, Crystal S Langlais, Shawn D St Peter, Charles M Leys, Daniel J Ostlie, R Todd Maxson, Todd Ponsky, David W Tuggle, James W Eubanks, Amina Bhatia, Adam C Alder, Cynthia Greenwell, Nilda M Garcia, Karla A Lawson, Prasenjeet Motghare, Robert W Letton
BACKGROUND: Age-adjusted pediatric shock index (SIPA) does not require knowledge of age-adjusted blood pressure norms, yet correlates with mortality, serious injury, and need for transfusion in trauma. No prospective studies support its validity. METHODS: A multicenter prospective observational study of patients 4-16years presenting April 2013-January 2016 with blunt liver and/or spleen injury (BLSI). SIPA (maximum heart rate/minimum systolic blood pressure) thresholds of >1...
September 23, 2016: Journal of Pediatric Surgery
Abha Singh, Ruchi Kishore, Saveri Sarbhai Saxena
AIM: To study the outcomes, benefits and complications of internal iliac artery ligation in both obstetric and gynecological cases. OBJECTIVE: To study the outcomes, effectiveness and complications of internal iliac artery ligation (IIAL). METHOD: This is an analytical longitudinal study done among women who have undergone internal iliac artery ligation in Dr. BRAMH a tertiary referral center from July 2013 to June 2015. Follow-up was done through color Doppler analysis of pelvic arteries before discharge, after 6 weeks and after 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
Julien Pottecher, François-Xavier Ageron, Clémence Fauché, Denis Chemla, Eric Noll, Jacques Duranteau, Laurent Chapiteau, Jean-François Payen, Pierre Bouzat
BACKGROUND: Early and accurate detection of severe hemorrhage is critical for a timely trigger of massive transfusion (MT). Hemodynamic indices combining heart rate (HR) and either systolic (shock index [SI]) or pulse pressure (PP) (PP/HR ratio) have been shown to track blood loss during hemorrhage. The present study assessed the accuracy of prehospital SI and PP/HR ratio to predict subsequent MT, using the gray-zone approach. METHODS: This was a retrospective analysis (January 1, 2009, to December 31, 2011) of a prospectively developed trauma registry (TRENAU), in which the triage scheme combines patient severity and hospital facilities...
October 2016: Journal of Trauma and Acute Care Surgery
Qin Qin, Yiqin Xia, Yu Cao
OBJECTIVE: Shock, the most common severe emergency syndrome, has a complicated etiopathogenesis, is difficult to identify, progresses quickly, and is dangerous. Early identification and intervention play determining roles in the final outcomes of shock patients, but no specific scoring system for shock has been established to date. METHODS: We collected 292 shock patients and analyzed the correlation between 28-day prognosis and the Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II), Modified Early Warning System (MEWS), and Sequential Organ Failure Assessment scoring systems...
September 2, 2016: Journal of Critical Care
Shannon N Acker, Brianne Hall, Lauren Hill, David A Partrick, Denis D Bensard
Introduction In the adult population, assessment of blood consumption (ABC) score [penetrating mechanism, positive focused assessment sonography for trauma (FAST), systolic blood pressure < 90, and heart rate (HR) > 120] ≥2 identifies trauma patients who require massive transfusion (MT) with sensitivity and specificity of 75 and 86%. We hypothesized that the adult criteria cannot be applied to children, as the vital sign cut-offs are not age-adjusted. We aimed to determine if the use of a shock index, pediatric age-adjusted (SIPA) would improve the discriminate ability of the ABC score in children...
August 17, 2016: European Journal of Pediatric Surgery
Stephen R Odom, Michael D Howell, Alok Gupta, George Silva, Charles H Cook, Daniel Talmor
CONTEXT: We noted a bimodal relationship between mortality and shock index (SI), the ratio of heart rate to systolic blood pressure. AIMS: To determine if extremes of SI can predict mortality in trauma patients. SETTINGS AND DESIGNS: Retrospective evaluation of adult trauma patients at a tertiary care center from 2000 to 2012 in the United States. MATERIALS AND METHODS: We examined the SI in trauma patients and determined the adjusted mortality for patients with and without head injuries...
July 2016: Journal of Emergencies, Trauma, and Shock
Masayasu Horibe, Tetsuji Kaneko, Naoto Yokogawa, Takuya Yokota, Osamu Okawa, Yukihiro Nakatani, Yuki Ogura, Juntaro Matsuzaki, Eisuke Iwasaki, Naoki Hosoe, Tatsuhiro Masaoka, John M Inadomi, Hidekazu Suzuki, Takanori Kanai, Shin Namiki
BACKGROUND: Assessment of the emergent endoscopy for upper gastrointestinal bleeding (UGIB) patients has important clinical implications. There is no validated criterion to triage. AIMS: To develop a simple score predicting an endoscopic intervention. METHODS: A prospective cohort study was conducted at a tertiary care centre. Primary outcome was the high-risk stigmata which were well-established endoscopic findings to determine the need for an endoscopic intervention...
October 2016: Digestive and Liver Disease
Mehdi Torabi, Shahrzad Moeinaddini, Amirhossein Mirafzal, Azam Rastegari, Neda Sadeghkhani
OBJECTIVES: To elucidate the predictive capability of shock index (SI), modified SI (MSI), and age SI for mortality in patients assigned to Emergency Severity Index (ESI) level 3 patients. METHODS: This was a retrospective medical record review performed in an academic internal medicine emergency department in Kerman, Iran. All patients older than 14 years triaged to ESI level 3 were enrolled in the study. Triage time vital signs were used to calculate SI, MSI, and age SI...
July 14, 2016: American Journal of Emergency Medicine
Scott C Fligor, Mark E Hamill, Katie M Love, Bryan R Collier, Dan Lollar, Eric H Bradburn
Early recognition of massive transfusion (MT) requirement in geriatric trauma patients presents a challenge, as older patients present with vital signs outside of traditional thresholds for hypotension and tachycardia. Although many systems exist to predict MT need in trauma patients, none have specifically evaluated the geriatric population. We sought to evaluate the predictive value of presenting vital signs in geriatric trauma patients for prediction of MT. We retrospectively reviewed geriatric trauma patients presenting to our Level I trauma center from 2010 to 2013 requiring full trauma team activation...
July 2016: American Surgeon
Shozo Kanezaki, Masashi Miyazaki, Naoki Notani, Hiroshi Tsumura
BACKGROUND: Elderly polytrauma patients with pelvic fractures are at higher risk than young adults for severe medical outcomes and/or death in the early post-trauma phase. The aim of our study was to identify predictive factors of medical severity among geriatric polytrauma patients. METHODS: We conducted a retrospective cross-sectional study of polytrauma patients treated at our center, who had a pelvic fracture and at least two other injuries with an abbreviated injury score ≥3...
July 22, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Yi Li, Xinchao Zhang, Peihong Lin, Haibo Qiu, Jie Wei, Yu Cao, Shuming Pan, Joseph Walline, Chuanyun Qian, Zhigang Shan, XueZhong Yu
The effect of Shenfu on biochemical parameters and survival during resuscitation in patients with septic shock was examined. This was a multicenter, controlled, randomized, open-label trial carried out in 210 patients with septic shock from seven medical centers in China. They were randomized to Shenfu or saline. The primary outcome was lactate clearance. The secondary outcomes were shock index normalization, dose of vasopressors, ICU stay, hospital stay, and mortality. A total of 199 patients completed the trial...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Cheng-Shyuan Rau, Shao-Chun Wu, Spencer C H Kuo, Kuo Pao-Jen, Hsu Shiun-Yuan, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh, Hang-Tsung Liu
OBJECTIVES: The shock index (SI) and its derivations, the modified shock index (MSI) and the age shock index (Age SI), have been used to identify trauma patients with unstable hemodynamic status. The aim of this study was to evaluate their use in predicting the requirement for massive transfusion (MT) in trauma patients upon arrival at the hospital. PARTICIPANTS: A patient receiving transfusion of 10 or more units of packed red blood cells or whole blood within 24 h of arrival at the emergency department was defined as having received MT...
2016: International Journal of Environmental Research and Public Health
Anderson Borovac-Pinheiro, Rodolfo C Pacagnella, Sirlei S Morais, Jose G Cecatti
OBJECTIVE: To assess variation in the shock index (SI; heart rate divided by systolic blood pressure) during pregnancy. METHODS: In a retrospective cohort study, data were assessed from the medical records of women with low-risk pregnancies who attended a primary healthcare unit for prenatal care in Campinas, Brazil, between January 2012 and December 2013. The means, standard deviations, and percentiles of SI values were calculated for different pregnancy lengths, stratified by body mass index (BMI) and maternal age...
October 2016: International Journal of Gynaecology and Obstetrics
Spencer C H Kuo, Pao-Jen Kuo, Shiun-Yuan Hsu, Cheng-Shyuan Rau, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh
OBJECTIVES: The presentation of decrease blood pressure with tachycardia is usually an indicator of significant blood loss. In this study, we used the reverse shock index (RSI), a ratio of systolic blood pressure (SBP) to heart rate (HR), to evaluate the haemodynamic status of trauma patients. As an SBP lower than the HR (RSI<1) may indicate haemodynamic instability, the objective of this study was to assess whether RSI<1 can help to identify high-risk patients with potential shock and poor outcome, even though these patients do not yet meet the criteria for multidisciplinary trauma team activation (TTA)...
2016: BMJ Open
Naoyuki Abe, Takashi Miura, Yusuke Miyashita, Naoto Hashizume, Soichiro Ebisawa, Hirohiko Motoki, Takuya Tsujimura, Takayuki Ishihara, Masaaki Uematsu, Toshio Katagiri, Ryuma Ishihara, Atsushi Tosaka, Uichi Ikeda
The admission shock index (SI) enables prediction of short-term prognosis. This study investigated the prognostic implications of admission SI for predicting long-term prognoses for acute myocardial infarction (AMI). The participants were 680 patients with AMI who received percutaneous coronary intervention. Shock index is the ratio of heart rate and systolic blood pressure. Patients were classified as admission SI <0.66 (normal) and ≥0.66 (elevated; 75th percentile). The end point was 5-year major adverse cardiac events (MACEs)...
June 14, 2016: Angiology
F G Zampieri, F Colombari
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Wei-Hung Lai, Shao-Chun Wu, Cheng-Shyuan Rau, Pao-Jen Kuo, Shiun-Yuan Hsu, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh
BACKGROUND: Hemorrhage is a leading cause of preventable trauma death. In this study, we used the reverse shock index (RSI), a ratio of systolic blood pressure (SBP) to heart rate (HR), to evaluate the hemodynamic stability of trauma patients. As an SBP lower than the HR (RSI < 1) may indicate hemodynamic instability, the objective of this study was to assess the associated complications in trauma patients with an RSI < 1 upon arrival at the emergency department (ED) (indicated as (A)RSI) and at the time of departure from the ED (indicated as (L)RSI) to the operative room or for admission...
2016: International Journal of Environmental Research and Public Health
Samiran Ray, Mirjana Cvetkovic, Joe Brierley, Daniel H Lutman, Nazima Pathan, Padmanabhan Ramnarayan, David P Inwald, Mark J Peters
BACKGROUND: Shock index (SI) (heart rate [HR]/systolic blood pressure [SBP]) has been used to predict outcome in both adult and pediatric sepsis within the intensive care unit (ICU). We aimed to evaluate the utility of SI before pediatric ICU (PICU) admission. PATIENTS AND METHODS: We conducted a retrospective observational study of children referred to a pediatric intensive care transport service (PICTS) between 2005 and 2011. The predictive value of SI, HR, and blood pressure at three prespecified time points (at referral to PICTS, at PICTS arrival at the referring hospital, and at PICU admission) and changes in SI between the time points were evaluated...
September 2016: Shock
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