Abstract:

Introduction: Modified shock index has been reported to be a useful in predicting early outcomes of trauma patients. The aims of this study was to determine the usefulness of modified shock index in predicting early outcomes among patient with trauma at Bugando Medical Centre.

Methodology: The prospective cross sectional study of all adult trauma patients (aged ≥ 18 years) with Kampala Trauma Score II of moderate to severe from January to May 2023 was conducted. The study was conducted at emergency department, intensive care unit and all surgical wards of Bugando Medical Centre. The modified shock index was calculated on arrival by dividing heart rate by the mean arterial pressure and its association to within 24 hours intensive care unit admission, blood transfusion, emergency surgical intervention, and mortality was determined. Collected data was analysed using STATA version 15.0. Predictors were run in multivariate regression model to ascertain statistical relationship.

Results: We enrolled 188 participants, majority were males 166(87.8%) and median age was 33.5 [IQR 25-41] years. Road traffic accident was the most common cause of injury accounting for 145(77.1%) participants. Head and neck was the most common body region affected followed by extremities in 123(65.4%) and 89(47.3%) respectively. Within 24 hours of admission, blood was transfused in 105(55.8%), emergency surgical intervention was 115(61.2%), intensive care unit admissions was 44(23.4%) patients, and 18(9.6%) patients died. High Modified Shock Index (MSI> 0.9) was found to be predictor of blood transfusion (OR=3.44; 95% [1.24-9.81], p-value =0.021), intensive care unit admission (OR=4.21, 95%CI [2.07-8.57], p-value <0.001] and mortality (OR = 2.82, 95%CI [2.36-9.92], p-value = 0.011) but not need for emergency surgical intervention (OR=1.66[0.88-3.13]; p-value = 0.115) within 24 hrs of admission.

Conclusion: High modified shock index was a predictor for blood transfusion, intensive care unit admission and mortality among trauma patients. We recommended that modified shock index (MSI) should be recorded in the patient chart upon initial assessment of trauma patients.