https://doi.org/10.4081/ecj.2026.14909
The value of the revised trauma score and shock index in patients admitted to the emergency department after an earthquake
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Published: 24 August 2026
During events like earthquakes that exceed hospital capacities, scoring systems are crucial for prioritizing the injured. This study assessed the predictive accuracy of the Revised Trauma Score (RTS), Shock Index (SI), Modified Shock Index (MSI), and Age-Specific Shock Index (ASI) for crush syndrome, blood transfusion need, intensive care requirement, and mortality in trauma patients post-earthquake. Data from 878 trauma patients (aged >18) admitted between February 6-20, 2023, were analyzed retrospectively. Outcomes included crush syndrome, blood transfusion need, hospitalization, intensive care requirement, and mortality. The SI and MSI strongly predicted crush syndrome (AUC=0.873; AUC=0.840). Both indices also accurately predicted blood transfusion need (AUC=0.831; AUC=0.794), mortality (AUC=0.930; AUC=0.908), intensive care requirement (AUC=0.889; AUC=0.874), and hospitalization (AUC=0.838; AUC=0.797). Across all outcomes, MSI and SI demonstrated better discriminatory performance than ASI and RTS. MSI outperformed SI statistically only for the prediction of crush syndrome and blood transfusion requirement. RTS may serve more to exclude than predict the adverse clinical outcomes analyzed.
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