休克指數對於外傷病人住院天數及預後之探討

Analysis of Shock Index as a Predictor of Length of Stay and Medical Outcomes among Trauma Patients

目的：本研究為分析不同特性外傷病人休克指數對住院天數及預後的影響。方法：本研究以病歷回溯方式，利用臺灣南部某醫學中心外傷資料庫2013～2015年18歲以上外傷病人共5,684名，分析年齡、休克指數、外傷嚴重度（Injury Severity Score，ISS）對住院天數及預後之相關性及差異性。結果：休克指數愈高，住院天數及ISS愈長；休克指數愈高，死亡率愈高；65歲以下非嚴重外傷及65歲以上嚴重外傷病人，休克指數對於住院天數沒有差異。年齡每增加一歲、ISS及休克指數每增加一分會增加0.009，2.858及0.445天的住院天數，而死亡則是存活的1.005，0.196及1.161倍。結論：休克指數可以做為預測外傷病人住院天數及預後的因子。此結果可以提供臨床評估、外傷病人轉至醫學中心及外傷醫師及早介入準備的依據。 Purpose: Shock index is a predictor of length of stay (LOS) and medical outcomes among trauma patients. This study determined the shock index and association between LOS and medical outcomes for different trauma patients. Material and Method: This was a retrospective study of 5,684 trauma patients aged > 17 years. We ascertained the differences and correlations between age, shock index, Injury Severity Score (ISS), LOS, and outcome for trauma patients admitted to a Tainan medical center from 2013 to 2015. Results: The higher the shock index was, the higher the ISS and mortality rate were; the higher the shock index was, the longer the LOS was. However, no difference in LOS was observed between the groups aged below 65 with ISS < 16 and groups aged over 65 with ISS ≥ 16. The LOS and mortality risk increased with age, ISS, and shock index by 0.009, 2.858, and 0.445 days and 1.005, 0.196, and 1.161 times, respectively. Conclusion: The shock index is a significant predictor of LOS and medical outcomes for trauma patients. This study can be used as a reference for managing different groups of trauma patients and provides evidence for emergent intervention/transfer to a medical center.