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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2025; 17(10): 109999
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.109999
Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.109999
Shock index and early warning score in liver cancer rupture shock
Ji-Fen Ma, Li Jin, Ling Sha, Hong-Fang Li, Xiang-Yun Qian, Hai-Yan Wang, Department of Emergency, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226000, Jiangsu Province, China
Co-corresponding authors: Xiang-Yun Qian and Hai-Yan Wang.
Author contributions: Ma JF designed the study; Ma JF, Jin L, Sha L, and Li HF contributed to the analysis of the manuscript; Ma JF and Jin L were involved in the data collection and writing of this article. All the authors have read and approved the final manuscript. Qian XY and Wang HY equally supervised the research and manuscript preparation (designated as co-corresponding authors). Qian XY and Wang HY, as co-corresponding authors, made equal and significant contributions to the research. They jointly supervised the entire research process, providing guidance on the implementation of the study design formulated by Ma JF. In terms of manuscript preparation, they worked collaboratively to oversee the refinement of the content, ensuring that the analysis and writing by Ma JF, Jin L, Sha L, and Li HF met academic standards. They also took shared responsibility for addressing issues that arose during the research and manuscript development, playing a crucial role in ensuring the quality and integrity of the work. Both are responsible for corresponding with relevant parties regarding the study.
Supported by Clinical Medicine Special Research Fund Project of Nantong University, No. 2024HZ001 and No. 2022HY009.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the Nantong Third People's Hospital and Affiliated Nantong Hospital 3 of Nantong University.
Informed consent statement: All study participants and their legal guardians provided written informed consent before enrollment.
Conflict-of-interest statement: The authors report no relevant conflicts of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang-Yun Qian, Dean, Department of Emergency, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, No. 60 Qingnian Middle Road, Chongchuan District, Nantong 226000, Jiangsu Province, China.
Received: July 1, 2025
Revised: August 1, 2025
Accepted: August 18, 2025
Published online: October 27, 2025
Processing time: 114 Days and 17 Hours
Revised: August 1, 2025
Accepted: August 18, 2025
Published online: October 27, 2025
Processing time: 114 Days and 17 Hours
Core Tip
Core Tip: This study demonstrated that combining the shock index (SI, heart rate/systolic blood pressure ratio) with the early warning score (EWS) significantly improves outcomes in primary liver cancer rupture hemorrhage. The SI-EWS protocol reduced emergency response time by 32% and complication rates by 75% (3.39% vs 13.56%), and increased patient satisfaction to 94.92%. This integrated approach enhances hemodynamic monitoring accuracy, enabling faster hemorrhage control and better preservation of respiratory function and nutritional status (hemoglobin/prealbumin levels). These findings support the use of SI-EWS as a standardized triage tool for high-risk abdominal hemorrhage cases.