休克指数与脉搏血氧饱和度比值预测急诊创伤患者死亡率。
The ratio of shock index to pulse oxygen saturation predicting mortality of emergency trauma patients.
机构信息
Department of Emergency Medicine, the First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Critical Care Medicine, the First Affiliated Hospital of Soochow University, Suzhou, China.
出版信息
PLoS One. 2020 Jul 23;15(7):e0236094. doi: 10.1371/journal.pone.0236094. eCollection 2020.
OBJECTIVE
To test the following hypothesis: the ratio of shock index to pulse oxygen saturation can better predict the mortality of emergency trauma patients than shock index.
METHODS
1723 Patients of trauma admitted to the Emergency Department of the First Affiliated Hospital of Soochow University from 1 November 2016 to 30 November 2019 were retrospectively evaluated. We defined SS as the ratio of SI to SPO2, and the mortality of trauma patients in the emergency department as end-point of outcome. We calculated the crude HR of SS and adjusted HR with the adjustment for risk factors including sex, age, revised trauma score (RTS) by Cox regression model. ROC curve analyses were performed to compare the area under the curve (AUC) of SS and SI.
RESULTS
The crude HR of SS was: 4.31, 95%CI (2.89-6.42) and adjusted HR: 3.01, 95%CI(1.86-4.88); ROC curve analyses showed that AUC of SS was higher than that of shock index (SI), and the difference was statistically significant: 0.69, 95%CI(0.55-0.83) vs 0.65, 95%CI (0.51-0.79), P = 0.001.
CONCLUSION
The ratio of shock index to pulse oxygen saturation is good predictor for emergency trauma patients, which has a better prognostic value than shock index.
目的
验证以下假说：休克指数与脉搏血氧饱和度比值（SS）预测急诊创伤患者死亡率的能力优于休克指数（SI）。
方法
回顾性分析 2016 年 11 月 1 日至 2019 年 11 月 30 日期间收治于苏州大学附属第一医院急诊科的 1723 例创伤患者。我们定义 SS 为 SI 与 SPO2 的比值，将急诊创伤患者的死亡率定义为结局终点。我们通过 Cox 回归模型计算 SS 和调整风险因素（包括性别、年龄、修订创伤评分（RTS））后的调整 HR。通过 ROC 曲线分析比较 SS 和 SI 的曲线下面积（AUC）。
结果
SS 的粗 HR 为：4.31，95%CI（2.89-6.42），调整 HR 为：3.01，95%CI（1.86-4.88）；ROC 曲线分析表明，SS 的 AUC 高于 SI，差异具有统计学意义：0.69，95%CI（0.55-0.83）vs 0.65，95%CI（0.51-0.79），P = 0.001。
结论
休克指数与脉搏血氧饱和度比值是急诊创伤患者的良好预测指标，其预后价值优于休克指数。
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