The sensitivity, specificity, positive predictive value, and negative predictive values of rSIG ≤ 14 were 0.71, 0.75, 0.49, and 0.89, respectively. Hosmer–Lemeshow goodness-of-fit test and area under the curve values for rSIG score were 0.29 and 0.76, respectively.
Patients with rSIG ≤ 14 had seven-fold increased risks of mortality than those without rSIG ≤ 14 (odds ratio: 7.64 95% confidence interval: 4.69–12.42). The median (interquartile range) ISS score was 20 (17–26). In-hospital mortality occurred in 24.7% patients. In total, 438 patients (mean age: 56.48 years 68.5% were males) were included in this study. Logistic regression and receiver operating characteristic analysis were used to evaluate the accuracy of rSIG score in predicting in-hospital mortality. Demographic data, vital signs, ISS scores, injury mechanisms, laboratory data, managements, and outcomes were included for the analysis.
This retrospective case control study recruited adult severe trauma patients (ISS ≥ 16) with head injury (head AIS ≥ 2) who presented to the ED of two major trauma centers between Januand May 31, 2017. However, rSIG has never been used to evaluate the mortality risk in adult severe trauma patients (Injury Severity Score ≥ 16) with head injury (head Abbreviated Injury Scale ≥ 2) in the emergency department (ED). Multiplying rSI by Glasgow Coma Scale (rSIG) can possibly predict better in-hospital mortality in patients with trauma. The reverse shock index (rSI), a ratio of systolic blood pressure (SBP) to heart rate (HR), is used to identify prognosis in trauma patients.
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