The Journal of emergency medicine · 2025
Triage Pediatric Age-Adjusted Shock Index as a Predictor of Hospital Admission.
СтатьяНазвание и аннотация: Перевод в очереди
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Adhikary Mishuka, Silver Ellen J, Fein Daniel M
Аннотация
BACKGROUND: Shock index (SI), the ratio of heart rate to systolic blood pressure, is a valuable prognostic tool for assessing shock severity and predicting morbidity and mortality in trauma. Emergency department (ED) triage SI shows promise as an alternative prognostic tool for predicting hospital admission and inpatient mortality in adults. Pediatric age-adjusted shock index (SIPA) has been validated for identification of mortality in children with blunt trauma.
OBJECTIVE: To determine whether ED triage SIPA can be used to predict disposition.
METHODS: Retrospective chart review of patients aged 4-20 years who were either admitted or discharged from a quaternary care pediatric ED in 2019. Initial SIPA values were characterized as high or low based on established age-based cutoffs. Association between high SIPA and inpatient admission was evaluated.
RESULTS: There were 29,064 eligible ED encounters in the study period. High triage SIPA was associated with female sex, age less than 12 years old, emergency severity index 1-2, and clinical conditions involving fever, sepsis, dehydration and respiratory distress. Overall, those with high triage SIPA were 2.4 (95% CI 2.21-2.60) times more likely to be admitted. Among admitted patients, high triage SIPA was associated with higher odds of intensive care unit admission (OR 3.2; 95% CI 2.5-4.2) and higher odds of rapid response (OR 3.9; 95% CI 1.8-8.7) within the first 24 hours on the inpatient unit.
CONCLUSION: Elevated triage SIPA is associated with higher odds of admission, intensive care unit admission and rapid response in first 24 hours of admission.
OBJECTIVE: To determine whether ED triage SIPA can be used to predict disposition.
METHODS: Retrospective chart review of patients aged 4-20 years who were either admitted or discharged from a quaternary care pediatric ED in 2019. Initial SIPA values were characterized as high or low based on established age-based cutoffs. Association between high SIPA and inpatient admission was evaluated.
RESULTS: There were 29,064 eligible ED encounters in the study period. High triage SIPA was associated with female sex, age less than 12 years old, emergency severity index 1-2, and clinical conditions involving fever, sepsis, dehydration and respiratory distress. Overall, those with high triage SIPA were 2.4 (95% CI 2.21-2.60) times more likely to be admitted. Among admitted patients, high triage SIPA was associated with higher odds of intensive care unit admission (OR 3.2; 95% CI 2.5-4.2) and higher odds of rapid response (OR 3.9; 95% CI 1.8-8.7) within the first 24 hours on the inpatient unit.
CONCLUSION: Elevated triage SIPA is associated with higher odds of admission, intensive care unit admission and rapid response in first 24 hours of admission.