Traumatic brain injury and variants of shock index

Abstract

Traumatic Brain Injury is a major cause of death and long-term disability. The early identification of patients at high risk of mortality is important for both management and prognosis. Although many modified scoring systems have been developed for improving the prediction accuracy in patients with trauma, few studies have focused on prediction accuracy and application in patients with traumatic brain injury. The shock index (SI) which was first introduced in the 1960s has shown to strongly correlate degree of circulatory shock with increasing SI. In this editorial we comment on a publication by Carteri et al wherein they perform a retrospective analysis studying the predictive potential of SI and its variants in populations with severe traumatic brain injury.

Keywords: Predictive tools; Traumatic brain injury; Shock index; Neurocardiogenic stress; Myocardial ischemia

Core Tip: Traumatic brain injury is associated with an unacceptable morbidity and mortality. Brain injury has been shown to increase acute cardiovascular disease risk in the form of neurocardiogenic shock. Shock index (SI) is recognized to be a reliable early indicator of hemodynamic instability compared to traditional vital signs. Early identification is crucial as it helps with risk stratification of patients and predict prognosis. There are numerous variants of SI proposed over the years with the more well studied one being age adjusted SI.