Construction of a risk model for traumatic shock patients with trauma-induced coagulopathy

DONG Junchan; HE Bin; WANG Meiying

doi:10.3969/j.issn.1002-7386.2024.20.016

Abstract：Objective To explore and analyze the risk factors for trauma-induced coagulopathy(TIC)in patients with traumatic shock,and to build a risk prediction model.Methods This was a retrospective study involving 217 patients with traumatic shock admitted to our hospital from January 2017 to December 2022.Patients with concurrent TIC were selected as the TIC group and those without concurrent TIC were selected as the non-TIC group.Univariate and multivariate Logistic regression analysis were performed to identify the risk factors for TIC in patients with traumatic shock,and a TIC risk prediction model was constructed.The receiver operating characteristic(ROC)curve was used to verify the predictive value of the model on the occurrence of TIC.Results Among 217 patients with traumatic shock,79(36.41％)cases were complicated with TIC.The 138 patients were included in the non-TIC group.Univariate analysis showed that there were significant differences in the injury severity score(ISS),hemoglobin(Hb),the Acute Physiologic Assessment and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,the Glasgow Coma Scale(GCS)score,multiple organ dysfunction syndrome(MODS),hypothermia and HCO between TIC group and non-Tic group(P＜0.05).Multivariate Logistic regression results showed that ISS score,hypothermia,APACHE Ⅱ score,MODS and Hb were significantly correlated with the risk of TIC in patients with traumatic shock(P＜0.05).The risk prediction model was constructed as follows:P=-4.209+1.752×ISS score+2.084× hypothermia+2.005 × APACHE Ⅱ score+1.106×MODS-1.059 ×Hb.The ROC curve was used to verify the prediction value of the model for TIC,with the area under the curve(AUC)of 0.876(P=0.000,95％CI:0.828-0.924),sensitivity of 89.90％,and specificity of 71.00％.Conclusion High ISS score,low body temperature,high APACHE Ⅱscore,MODS and low Hb are important factors for the complication of TIC in patients with traumatic shock.The prediction model constructed based on these factors has a good predictive value for TIC,which is worthy of further clinical exploration and analysis.