Age Matters: Shock Index is a Superior Predictor in Geriatric Trauma Care

NYMC Faculty Study Reveals Even Slight Increases in Shock Index Heighten Mortality Risk in Elderly Patients

August 20, 2024
Kartik Prabhakaran, M.D.
Kartik Prabhakaran, M.D.

Shock index (SI), a known indicator of unfavorable outcomes in trauma, was found to be a more robust predictor of prognosis in geriatric patients with severe trauma as compared to younger patients in a new study by New York Medical College (NYMC) faculty that was recently published in The Journal of Surgical Research.

“The SI has emerged as a valuable tool for assessing the degree of shock in trauma patients, providing a simple yet effective means to evaluate circulatory compromise based on vital signs and help health care providers make critical triage decisions and effectively allocate and prioritize resources,” says Kartik Prabhakaran, M.D., professor of surgery. “Our findings underscore the critical significance of the SI as an invaluable prognostic indicator in geriatric patients facing severe trauma.”

Notably, the study reveals a heightened predictive strength of the SI in the elderly compared to younger counterparts. “Geriatric patients with each 0.1 increase in SI face a 12.3 percent higher risk of mortality, accentuating the SI's role in predicting life-threatening consequences,” says Dr. Prabhakaran. “The study also illuminates a compelling link between increased SI values and certain medical interventions in geriatrics, indicating a 31.8 percent increased likelihood of blood transfusions and 64.8 percent increased odds of undergoing major surgical intervention. These results highlight the SI's potential to guide clinical decision-making and optimize care strategies for elderly individuals.”

The researchers also sought to improve the comprehension of the SI's suitability for a range of patient demographics by examining the impact of age-related physiological changes.

“Age-related changes in the hemodynamic system reduce the capacity for compensatory reactions to stress. As people age, the vascular system may become less elastic, and conditions like atherosclerosis and hypertension become more prevalent. Consequently, SI readings in elderly people may be affected,” says Dr. Prabhakaran. “Therefore, tailoring SI interpretations to age-specific thresholds is crucial for accurately assessing risks and ensuring timely interventions, ultimately enhancing clinical outcomes for geriatric trauma patients.”