The predictive value of combined PT,INR and shock index for deep venous thrombosis in patients with multiple injuries

Xu Zhixia; Gou Yi; Ailikuti Aikepaer; Jia Wenting; Li Dandan; Yang Jianzhong; Feng Ke

doi:10.3969/j.issn.1002-1949.2026.02.005

Abstract：Objective To evaluate the predictive value of a combination of prothrombin time(PT),international normalized ratio(INR),and shock index(SI)for deep venous thrombosis(DVT)in patients with polytrauma.Methods In this retrospective case-control study,we analyzed the clinical data of 342 patients with polytrauma admitted between June 2022 and December 2024 to the General Hospital of Ningxia Medical University.Based on the presence of DVT,the patients were divided into the DVT group(61 cases)and the non-DVT group(281 cases).A comparison of the following indicators was made between the two groups:age,gender,BMI,underlying diseases,and injury sites;heart rate,respiratory rate,systolic blood pressure,diastolic blood pressure,SI,white blood cell count,lactic acid level,blood glucose level,PT,APTT,prothrombin activity,INR,platelet count,FIB level,and D-dimer within the first 24 hours after admission;ISS,GCS,and Caprini score within the first 24 hours after admission;conditions of blood transfusion,hemostasis,and deep vein catheterization within 24 hours after admission;and LOS in ICU.Univariate analysis and multivariate Logistic regression were employed to assess and pinpoint the factors influencing DVT following polytrauma.Additionally,ROC curves were generated to evaluate the predictive performance of these identified factors.Results The DVT group had significantly higher values in age,BMI,heart rate,respiratory rate,SI,lactic acid,blood glucose,PT,INR,D-dimer,ISS,Caprini score,the proportion of patients receiving tranexamic acid treatment within 24 hours post-injury,the proportion of patients undergoing deep vein catheterization,and LOS in ICU.In contrast,the prothrombin activity and GCS score were significantly lower in the DVT group than in the non-DVT group,with all differences reaching statistical significance(P＜0.05).The results of multivariate Logistic regression analysis showed that age(OR=1.037,95％CI 1.004-1.072,P=0.027),SI(OR=5.976,95％CI 1.514-23.584,P=0.011),INR(OR=1.104,95％CI 1.014-1.202,P=0.023),and GCS(OR=0.882,95％CI 0.799-0.974,P=0.013)were significantly correlated with the formation of DVT in patients with multiple injuries(P＜0.05).Age,SI,PT,INR,and GCS alone showed poor predictive performance of DVT formation in patients with multiple injuries(AUC＜0.70),while the combined prediction using PT,INR,and SI demonstrated good predictive value(AUC=0.838);its performance was close to that of the combined prediction using all the above indicators(AUC=0.847),with both sensitivity and specificity improved.Conclusions The combination of PT,INR,and SI upon admission shows good predictive value for DVT in polytrauma patients and may aid in early risk stratification.