Combination of reverse shock index and simplified motor score as a strong discriminator of trauma outcomes
Creators: name: Wu, Meng-Yu
name: Yiang, Giou-Teng
name: Chien, Ding-Kuo
name: Chen, Sy-Jou
name: Chu, Chi-Ming
name: Chung, Jui-Yuan
name: Ma, Hon-Ping
name: Lin, Mau-Roung
Publisher: name: Taylor & Francis
Year: 2025
Subjects: subject: Medicine
subject: Microbiology
subject: FOS: Biological sciences
subject: Biotechnology
subject: Chemical Sciences not elsewhere classified
subject: Biological Sciences not elsewhere classified
subject: Information Systems not elsewhere classified
subject: Science Policy

description: The reverse shock index multiplied by simplified motor score (rSI-sMS) is a novel and rapid measure for assessing injury severity in patients with trauma in prehospital settings; however, its discriminant ability requires further validation. A retrospective cohort study was conducted from trauma database of Taipei Tzu Chi Hospital to compare the accuracy of the rSI-sMS with that of the shock index, modified shock index, reverse shock index multiplied by the Glasgow Coma Scale (rSI-GCS), and the reverse shock index multiplied by GCS motor subscale (rSI-GCSM) for discriminating in-hospital mortality, intensive care unit (ICU) admissions, prolonged ICU stays ≥14 days, and prolonged hospital stays ≥30 days in patients with trauma. A total of 11,760 patients from the trauma database were included. rSI-sMS had significantly better accuracy in discriminating in-hospital mortality, ICU admissions, prolonged ICU stays (≥14 days), and prolonged hospital stays (≥30 days) than the shock index, modified shock index, and rSI-GCSM, whereas its accuracy was similar to that of the rSI-GCS. Furthermore, rSI-sMS had better accuracy for discriminating clinical outcomes in patients with an injury severity score (ISS) ≥16, motor vehicle collisions, falls, no chronic disease, and cardiovascular disease as well as in geriatric and nongeriatric patients. In patients with mixed and isolated brain injuries, rSI-sMS accurately discriminated the four clinical outcomes, similar to rSI-GCS. The optimal cutoff value of rSI-sMS had a discriminant ability of 85.0, 78.6, 75.2, and 81.0% for in-hospital mortality, ICU admissions, ICU stay ≥14 days, and hospital stays of ≥30 days, respectively. Compared with the shock index, modified shock index, and rSI-GCSM, rSI-sMS is a more accurate field triage scoring system for discriminating in-hospital mortality, ICU admissions, prolonged ICU stay, and prolonged hospital stays in patients with trauma. The rSI-sMS had significantly better accuracy for discriminating in-hospital mortality, intensive care unit (ICU) admissions, prolonged ICU stays, and prolonged hospital stays than other triage tools, including the shock index, modified shock index, and the reverse shock index multiplied by the Glasgow Coma Scale motor subscale.The results suggest that rSI-sMS is a rapid and accurate triage tool for discriminating mortality, ICU admissions, prolonged ICU stays, and prolonged hospital stays in patients with trauma. The rSI-sMS had significantly better accuracy for discriminating in-hospital mortality, intensive care unit (ICU) admissions, prolonged ICU stays, and prolonged hospital stays than other triage tools, including the shock index, modified shock index, and the reverse shock index multiplied by the Glasgow Coma Scale motor subscale. The results suggest that rSI-sMS is a rapid and accurate triage tool for discriminating mortality, ICU admissions, prolonged ICU stays, and prolonged hospital stays in patients with trauma.