Pattern and Distribution of Shock Index and Age Shock Index Score Among Trauma Patients in Towards Improved Trauma Care Outcomes (TITCO) Dataset

Prashant Bhandarkar, Ashok Munivenkatappa, Nobhojit Roy, Vineet Kumar, Luis Rafael Moscote-Salazar, Amit Agrawal


Objective: To compare the shock index (SI – which is the ratio of heart rate to systolic blood pressure) and Age SI (Age in years multiplied by SI) with survival outcome of the patients across multicenter trauma registry in India.

Methods: Study is based on Towards Improved Trauma Care Outcomes (TITCO) project. Records with valid details of age, heart rate, systolic blood pressure, Injury Severity Scale (ISS) and Glasgow Coma Scale (GCS) score was considered. SI was categorized into four groups; Group I (SI<0.6) as no shock, group II (SI ≥0.6 to <1.0) as mild shock, group III (SI ≥1.0 to <1.4) as moderate shock and group IV (SI ≥1.4) as severe shock. Age SI was categorized decade wise into six groups. Mortality was dependent variable. GCS and ISS were considered as secondary variables.

Results: 10843 participants from TITCO registry satisfying inclusion-exclusion criteria were considered for study. Mean SI score in group I to IV was increasing with 0.53 to 1.72 respectively. Age SI was seen to be increasing across its six groups. Gender wise no difference was found among SI group. For severe ISS and critical ISS, mortality in SI group IV was 50% and 56 % respectively. Mortality was increasing across mild to severe GCS among all SI groups.

Conclusion: The categorized SI and Age SI had shown increase in death percentages from mild to severe severity of injuries. Similar to GCS and ISS, SI and Age SI should also be calculated and categorized in all health care and further plan for management aspects.


Shock index; Age shock index; Heart rate; Blood pressure; Mortality; Trauma

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