Reverse shock index multiplied by Glasgow coma scale (rSIG) to predict mortality in traumatic brain injury: systematic review and meta-analysis

Vásquez-Tirado G.A.; Meregildo-Rodríguez E.D.; Quispe-Castañeda C.V.; Cuadra-Campos M.; Guzmán-Aguilar W.M.; Abanto-Montalván P.H.; Alva-Guarniz H.; Liñán-Díaz L.J.; Rodríguez-Chávez L.Á. · Medicina Intensiva (2025) · DOI: 10.1016/j.medin.2025.502149

Resumen

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%).

Instituciones: Universidad Nacional de Trujillo; Universidad Privada Antenor Orrego; Universidad Señor de Sipán