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Original article
Available online 20 January 2025
Reverse shock index multiplied by Glasgow coma scale (rSIG) to predict mortality in traumatic brain injury: systematic review and meta-analysis
Producto del índice de shock inverso por la Escala de Coma de Glasgow (rSIG) para predecir la mortalidad en traumatismo craneoencefálico: revisión sistemática y metaanálisis
Gustavo Adolfo Vásquez-Tiradoa,b,
Corresponding author
gavt13@gmail.com

Corresponding author.
, Edinson Dante Meregildo-Rodríguezc, Claudia Vanessa Quispe-Castañedaa, María Cuadra-Camposa, Wilson Marcial Guzmán-Aguilarb,d, Percy Hernán Abanto-Montalvánb,d, Hugo Alva-Guarniza, Leslie Jacqueline Liñán-Díaza, Luis Ángel Rodríguez-Cháveza
a Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Peru
b Unidad de Cuidados Intensivos, Hospital Regional Docente de Trujillo, Trujillo, Peru
c Escuela de Posgrado. Universidad Señor de Sipán
d Facultad de Medicina, Universidad Nacional de Trujillo, Trujillo, Peru
Received 28 October 2024. Accepted 29 November 2024
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Tables (3)
Table 1. General characteristics of included studies.
Table 2. Risk of bias of the included studies.
Table 3. Certainty of Evidence through GRADE. Patients with traumatic brain injury and low rSIG values have a 24% increased risk of in-hospital mortality, with a moderate level of certainty.
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Abstract
Objective

To determine whether the Reverse Shock Index multiplied by the Glasgow Coma Scale (rSIG) is a predictor of in-hospital mortality in patients with traumatic brain injury (TBI).

Design

This is a systematic review and meta-analysis.

Setting

A comprehensive search was conducted in five databases for studies published up to May 22, 2024, using a PECO strategy. Eight studies were identified for quantitative analysis and included in our meta-analysis.

Participants

The participants of the included primary studies.

Interventions

Patients with a low rSIG as a predictor of in-hospital mortality in TBI.

Main variables of interest

rSIG, in-hospital mortality, TBI.

Results

Our meta-analysis evaluated a total of eight observational studies encompassing 430,000 patients with TBI, observing 6,417 deaths (15%). After performing a sensitivity analysis, we found that patients with TBI and a low value of the reverse shock index multiplied by the Glasgow Coma Scale (rSIG) had a 24% higher risk of death (OR 1.24; 95% CI 1.12–1.38; I²: 96%). Furthermore, rSIG values were significantly higher in survivors compared to those who died (MD 7.72; 95% CI 1.86–13.58; I²: 99%).

Keywords:
Traumatic brain injury
Mortality
rSIG
Systematic review
Meta-Analysis
Resumen
Objetivo

Determinar si el rSIG Índice de shock inverso multiplicado por la escala de coma de Glasgow (rSIG) es un predictor de mortalidad intrahospitalaria en pacientes con trauma craneoencefálico (TBI).

Diseño

Se presenta una investigación tipo Revisión sistemática y Metaanálisis.

Ámbito

Realizamos una búsqueda exhaustiva en cinco bases de datos de estudios publicados hasta el 22 de mayo de 2024, utilizando una estrategia PECO. Se identificaron ocho estudios para el análisis cuantitativo, los cuales fueron incluidos en nuestro metaanálisis.

Pacientes

Los participantes de los estudios primarios incluidos.

Intervenciones

Pacientes con rSIG alto como predictor de mortalidad intrahospitalaria en TBI.

Variables de interés principales

rSIG, mortalidad intrahospitalaria, TBI.

Resultados

Nuestro metaanálisis evaluó un total de ocho estudios observacionales, que abarcaban 430,000 pacientes con TCE y observaron 6,417 muertes (15%). Tras realizar un análisis de sensibilidad, encontramos que los pacientes con TCE y un valor bajo del índice de shock inverso multiplicado por la escala de coma de Glasgow (rSIG) presentaban un 24% mayor riesgo de muerte (OR 1.24; IC 95% 1.12–1.38; I²: 96%). Además, los valores de rSIG fueron significativamente más altos en los sobrevivientes en comparación con aquellos que fallecieron (DM 7.72; IC 95% 1.86–13.58; I²: 99%).

Conclusiones

En los pacientes con TBI, el rSIG actúa como un predictor de mortalidad, con un riesgo de muerte un 24% mayor en aquellos con valores bajos.

Palabras clave:
Traumatismo craneoencefálico
Mortalidad
rSIG
Revisión sistemática
Metaanálisis

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