Predicting Factors for Shock Status in Injured Patients admitted to the Emergency Room
Keywords:
Injured patient, Shock index, Emergency severity index, Rapid emergency medicine scoreAbstract
This research aimed to study the predicting factors including age, Emergency severity index triage level, Rapid emergency medicine score, mode of transportation and duration of injury to hospital, and their power to predict shock status in emergency patients admitted to the emergency room at Phrae hospital. Predictive correlation research design, participants included 200 emergency patients were treated at Phrae hospital. Data were retrospectively collected by reviewing patient medical records and injury surveillance documentation during November 2019 – April 2020. Four instruments were used to collect data: 1) a personal information questionnaire 2) the Emergency severity index (ESI) 3) the Rapid emergency medicine score (REMS) 4) the Shock Index (SI). Data was analyzed by t-test, Wilcoxon Rank sum test and Binary logistic regression analysis.
The results showed most of the samples were male (65.5 person) and average age 48.2 years (SD=18.4). Most of the injuries were traffic accidents (48.5%) and 37.0% access to the hospital by self-transportation. The time taken from the incident to the hospital was longer than 60 minutes (63.0%). Patients had a state of shock in 54.5% (SI> 0.7). Age, severity of patients at the separation point (ESI triage level) and hospital delivery type were associated with shock conditions (p <.001, .001, .037). Analysis of predictive power showed that over 60 years of age decreased the risk of shock (OR = .317, 95% CI = .13-.79). The severity of ESI triage levels 1 and level 2 increased the risk of shock by 7.7 times (95% CI = 2.17-27.20) and 3.39 times (95% CI = 1.18-10.07), respectively.
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