Prognostic Value Of Different Shock Indexes In Patients With Acute Craniocerebral Trauma

Objective: Acute craniocerebral trauma is a common severe traumatic disease in clinic,which seriously threatens the life safety of patients.How to accurately predict the progression of craniocerebral trauma in early stage and improve the prognosis through active and effective intervention has become a hot issue of medical attention.Due to its advantages of simple and easy to obtain,rapid and non-invasive,shock index is often used to judge the severity of the condition and predict the prognosis of patients with shock,postpartum hemorrhage,acute trauma,myocardial infarction,pulmonary embolism and sepsis.This study analyzed and studied the prognostic value of different shock indexes in patients with acute craniocerebral trauma,in an attempt to provide reliable clinical diagnosis and treatment data for clinicians to conveniently and accurately assess the degree of acute craniocerebral injury,so as to give targeted treatment to patients in a more timely and accurate manner,further assist clinicians to carry out early intervention and improve the prognosis of patients.Methods: Based on retrospective analysis,this study retrospectively analyzed the data of acute craniocerebral trauma patients admitted to Shengjing Hospital Affiliated to China Medical University from January 2019 to December 2021,and compared the efficacy of shock index,age shock index,modified shock index and rSIG shock index in evaluating the prognosis of patients with craniocerebral trauma.The evaluation indexes included the AUC value,sensitivity and specificity obtained by SPSS medical statistics software.The28-day mortality of patients with acute craniocerebral trauma was used as the observation endpoint to compare which shock index had the greatest significance in the prognosis assessment of acute craniocerebral trauma.At the same time,the general situation of patients,whether they have underlying diseases,laboratory indicators,whether they have tracheotomy,surgery and other factors were collected to assess whether there was any influence on the prognosis of patients.Result:1.A total of 400 patients with craniocranial trauma who met the inclusion and exclusion criteria were included in the statistical analysis.The P values of age,admission GCS,time from injury to admission,hypertension and illness were all < 0.05,indicating that age,proportion of hypertension and illness in the death group were higher than those in the survival group,and admission GCS and time from injury to admission in the death group were lower than those in the survival group.2.Compared with laboratory indicators,high AST,high ALT,high Cr,high BUN and high WBC are risk factors for death in patients with acute craniocerebral trauma.Each unit increase of these indicators increases the risk of death in patients with acute craniocerebral trauma by 1.007,1.008,1.025,1.131,1.115 times.High PLT was a protective factor in patients with acute brain injury,and the risk of death after acute brain injury was reduced by 0.992 times for each unit increase in PLT.3.There was no significant difference between the ROC curve of GCS score and rSIG shock index(P > 0.05).In conclusion,both GCS score and rSIG shock index on admission are good indicators to evaluate the prognosis of patients with acute craniocerebral trauma.4.The AUC values corresponding to shock index,age shock index,modified shock index and rSIG shock index were 0.772,0.794,0.786 and 0.953.Conclusion: Shock index,modified shock index,age shock index and rSIG shock index are important basis for evaluating the severity of the disease and predicting the prognosis of patients with craniocerebral trauma,and they have certain predictive value in the severity of the disease and prognosis evaluation at 28 days.By comparing the AUC corresponding to the above four shock indexes,it is concluded that rSIG shock index has the highest diagnostic value for the prognosis of patients with acute craniocerebral trauma,and is an effective predictor for evaluating the severity of patients’ disease and prognosis.Dynamic monitoring of the change trend of rSIG shock index can assist medical staff to quickly understand the condition of patients with craniocerebral trauma and effectively treat them.Thus,the disability rate and mortality of patients can be reduced to a certain extent.