Índice de shock corregido como predictor de shock hemorrágico en heridos por arma de fuego. Hospital General Monte Sinaí. 2019 - 2023.

Abstract

Firearm trauma is one of the leading causes of death in Ecuador, and massive transfusion is a critical factor in the management of these patients. The objective of this study is to evaluate the Corrected Shock Index (CSI) as a predictor of the need for massive transfusion in patients with firearm trauma, and consequently, hemorrhagic shock. A retrospective observational study was carried out within the Monte Sinaí General Hospital, we based it on the clinical history of 547 patients, who were treated in the period 2019-2023. Among the variables used in our study, the corrected shock index (CSI), the ATLS scale and serum lactate were analyzed, correlating them in turn with the need for massive transfusion. ROC curves were used to determine the sensitivity and specificity of our variables. The results showed that CSI has a high correlation with the need for massive transfusion, with a sensitivity of 85% and a specificity of 70%. The ATLS scale and serum lactate also showed good predictive results, but CSI stood out for its simplicity and effectiveness. Additionally, a direct relationship was observed between an elevated CSI and an increase in hospital stay days and mortality. In conclusion, CSI is an effective tool for predicting the need for massive transfusion in patients with firearm trauma. Its inclusion in initial management protocols in emergency settings, especially in resource-limited hospitals, is recommended.