Insights into the role of the shock index and its derivatives in triage

A BSTRACT Trauma is a considerable global public health concern. In Taiwan, the Taiwan Trauma Registry was established in 2005 through collaboration between the Formosa Association for the Surgery of Trauma and the government. However, the registry has not yet achieved full national integration, which limits its utility for research and policymaking. To address this gap, we integrated data from the four hospitals of the Tzu Chi Medical Foundation, which are located in northern, central, southern, and eastern Taiwan. This newly developed Tzu Chi Trauma Registry reflects the diverse characteristics of regional emergency medical service systems and provides a foundation for optimizing trauma care models and developing targeted injury prevention and clinical intervention programs. This review summarizes current tools for prehospital and in-hospital triage, focusing on the shock index and its derivatives. This review also discusses the predictive value of combining hemodynamic indices with neurological assessment tools with respect to clinical outcomes in patients with trauma, including predicting the need for transfusion, the need for massive transfusion protocol activation, and mortality. By performing a retrospective analysis of the Tzu Chi Trauma Registry, we aim to improve the accuracy of triage decision-making by reducing overtriage and undertriage, thereby enhancing the quality of trauma care and improving patient outcomes.