Analysis on the efficacy of FDP and D-D combined with PLT in predicting survival prognosis of patients with trauma-induced coagulopathy

WANG Yaxin; QIAN jing; YANG Wendi; LANG Di; MA Yongxin; ZHANG Hongwei; LI Haisheng; ZHAO Xiaoli

doi:10.3969/j.issn.1674-3806.2024.05.11

Abstract：Objective To analyze the the efficacy of fibrinogen degradation products(FDP)and D-dimer(D-D)combined with platelet(PLT)in predicting survival prognosis of patients with trauma-induced coagulopathy(TIC).Methods The clinical data of 182 trauma patients admitted to the First Hospital of Kunming from February 2020 to February 2023 were retrospectively collected.According to the occurrence of TIC,the patients were divided into TIC group(85 cases)and non-TIC group(97 cases).The clinical data were compared between the two groups,and the effects of FDP,D-D and PLT levels in the TIC patients at admission on the occurrence of death within 30 days after admission were explored by using multivariate logistic regression analysis,and the predictive efficacy of the above indicators was analyzed by using receiver operating characteristic(ROC)curve.Results The levels of injury severity score(ISS),prothrombin time(PT),activated partial thromboplastin time(APTT),prothrombin time ratio(PTR),international normalized ratio(INR)and death rate in the TIC group were higher than those in the non-TIC group,while the levels of fibrinogen(Fib),PLT and hemoglobin(Hb)in the TIC group were lower than those in the non-TIC group,and the differences were statistically significant(P＜0.05).Among the TIC patients,59 cases survived and 26 cases died within 30 days after admission.The FDP and D-D levels in the survival group were significantly lower than those in the death group(P＜0.05),and the PLT level in the survival group was significantly higher than that in the death group(P＜0.05).There was no sta-tistically significant difference in Fib level between the two groups(P＞0.05).After adjusting the factors of age,gender,length of hospital stay and ISS,the results of multivariate logistic regression analysis showed that the elevated levels of FDP[OR(95％CI)=1.021(1.007-1.036)]and D-D[OR(95％CI)=1.087(1.027-1.250)]were risk factors for promoting death in the patients(P＜0.05),and the elevated level of PLT[OR(95％CI)=0.990(0.983-0.997)]was a protective factor for inhibiting death in the patients(P＜0.05).The results of ROC curve analysis showed that FDP,D-D and PLT could effectively predict the occurrence of death within 30 days after admission in the TIC patients(P＜0.05),and the predictive efficacy of combining these three indicators was higher[AUC(95％CI)=0.823(0.720-0.925),P＜0.001].Conclusion Detection of FDP,D-D and PLT indicators at admission is helpful to evaluate the survival prognosis of TIC patients,which is worth the attention of clinical physicians.