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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Metrics of shock in pediatric trauma patients: A systematic search and review
Injury, v 52(10), pp 3166-3172
Oct 2021
PMID: 34238538
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
•The association between shock metrics and morbidity and mortality following trauma is not well defined in pediatric trauma patients.•Systolic blood pressure (SBP), shock index (SI), and shock index, pediatric age adjusted (SIPA) are the most commonly studied metrics.•As a predictor for mortality and blood transfusion, SI was the most sensitive predictor of outcomes, followed by SIPA, then SBP.•SBP was the most specific predictor of mortality and blood transfusion, followed by SIPA, then SI.•Future studies should include direct comparison of all three metrics to best address the relative value of each.
Shock-index (SI) and systolic blood pressure (SBP) are metrics for identifying children and adults with hemodynamic instability following injury. The purpose of this systematic review was to assess the quality of these metrics as predictors of outcomes following pediatric injury.
We conducted a literature search in Pubmed, SCOPUS, and CINAHL to identify studies describing the association between shock metrics on the morbidity and mortality of injured children and adolescents. We used the data presented in the studies to calculate the sensitivity and specificity for each metric. This study was registered with Prospero, protocol CRD42020162971.
Fifteen articles met the inclusion criteria. seven studies evaluated SI or SIPA score, an age-corrected version of SI, as predictors of outcomes following pediatric trauma, with one study comparing SIPA score and SBP and one study comparing SI and SBP. The remaining eight studies evaluated SBP as the primary indicator of shock. The median sensitivity for predicting mortality and need for blood transfusion was highest for SI, followed by SIPA, and then SBP. The median specificity for predicting these outcomes was highest for SBP, followed by SIPA, and then SI.
Common conclusions were that high SIPA scores were more specific than SI and more sensitive than SBP. SIPA score had better discrimination for severely injured children compared to SI and SBP. An elevated SIPA was associated with a greater need for blood transfusion and higher in-hospital mortality. SIPA is specific enough to exclude most patients who do not require a blood transfusion.
Metrics
Details
- Title
- Metrics of shock in pediatric trauma patients: A systematic search and review
- Creators
- Emily C. Alberto - Children’s National Health SystemElise McKenna - Children’s National Health SystemMichael J. Amberson - Children’s National Health SystemJun Tashiro - Children’s National Health SystemKatie Donnelly - Children’s National Health SystemArunachalam A. Thenappan - Children’s National Health SystemPeyton E. Tempel - Children’s National Health SystemAdesh S. Ranganna - Children’s National Health SystemSusan Keller - Children’s National Health SystemIvan Marsic - Rutgers, The State University of New JerseyAleksandra Sarcevic - Drexel UniversityKaren J. O'Connell - Children’s National Health SystemRandall S. Burd - National Hospital
- Publication Details
- Injury, v 52(10), pp 3166-3172
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Information Science
- Web of Science ID
- WOS:000713283700033
- Scopus ID
- 2-s2.0-85117985450
- Other Identifier
- 991019169668104721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Emergency Medicine
- Orthopedics
- Surgery