Predictive value of D-dimer/fibrinogen ratio combined with GCS score for early neurological deterioration in patients with moderate traumatic brain injury
WANG Ru-hai
WANG Shen
LI Chun
YANG Zhen
SUN Fei-lin
ZHANG Cheng
LI Xi-zhen
Abstract：Objective To investigate the predictive value of the D-dimer to fibrinogen(D/F)ratio combined with the Glasgow Coma Scale(GCS)score for early neurological deterioration(END)in patients with moderate traumatic brain injury(TBI).Methods A retrospective analysis was conducted on the clinical data of 265 patients with moderate TBI admitted between January 2018 and April 2023.END was defined as a decline of≥2 points in GCS score or neurological deterioration requiring surgical intervention within 72 hours of admission.Multivariate logistic regression analysis was used to identify risk factors for END,and receiver operating characteristic(ROC)curves were employed to evaluate predictive performance.Results Among the 265 patients,46(17.4%)developed END.Multivariate logistic regression revealed that a lower GCS score on admission(OR=0.539;95%CI:0.344～0.844;P=0.007)and an elevated D/F ratio(OR=1.225;95%CI:1.008～1.489;P=0.041)were independent risk factors for END in moderate TBI.The area under the ROC curve(AUC)for the D/F ratio and GCS score in predicting END was 0.777(95%CI:0.722～0.826)and 0.624(95%CI:0.562～0.682),respectively.The combination of D/F ratio and GCS score achieved an AUC of 0.820(95%CI:0.769～0.864).Conclusion An elevated D/F ratio serves as a significant predictor of END in moderate TBI patients.The combination of D/F ratio and GCS score demonstrates superior predictive value for END in this population.
Keywords：Moderate traumatic brain injuryEarly neurological deteriorationD-dimer/fibrinogen ratioGlasgow Coma Scale
Publication Date：2025-02-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 77-82 )