Predictive value of reverse shock index and Glasgow Coma Scale score product index combined with serum fibrinogen and C-reactive protein levels for the prognosis of patients with multiple injuries

Zhang Ming; Zhang Hongying; Yang Qiulan; Zhang Xia; Huang Kaifei

doi:10.3760/j.issn.1673-4777.2024.07.017

Abstract：Objective To explore the predictive value of reverse shock index and Glasgow Coma Scale score product(rSIG)index combined with serum fibrinogen(FIB)and C-reactive protein(CRP)levels in the prognosis of patients with multiple injuries.Methods A total of 140 patients with multiple injuries admitted to Department of Emergency,North China University of Science and Technology Affiliated Hospital from February 2022 to March 2023 were selected as the main observation objects.The patients were divided into survival group(120 cases)and death group(20 cases)according to their survival status 28 d after injury.Another 100 healthy people were selected as control subjects.The level of serum FIB was detected by automatic coagulation analyzer,and the level of CRP was detected by immune scattering turbidimetry.Pearson method was used to analyze the correlation between rSIG index and serum FIB and CRP levels.Cox regression method was used to analyze the influencing factors of death in patients with multiple injuries.The receiver operating characteristic curve was used to analyze the predictive value of rSIG index combined with serum FIB and CRP levels for the prognosis of patients with multiple injuries.Results The serum FIB level of patients with multiple injuries was lower than that of healthy people[(2.2±0.4)g/L vs(2.9±0.5)g/L],and the CRP level was higher than that of healthy people[(36±8)mg/L vs(7±3)mg/L](both P＜0.001).The serum FIB level of the survival group was higher than that of the death group[(2.3±0.4)g/L vs(1.6±0.4)g/L],and the CRP level was lower than that of the death group[(34±8)mg/L vs(47±8)mg/L](both P＜0.001).The rSIG index of the survival group were higher than those of the death group(P＜0.05).Pearson analysis showed that serum FIB was negatively correlated with CRP level(r=-0.446,P＜0.001)and positively correlated with rSIG index(r=0.473,P＜0.001),and serum CRP level was negatively correlated with rSIG index(r=-0.536,P＜0.001).Cox regression analysis showed that FIB,CRP and rSIG index were the influencing factors of death in patients with multiple injuries(all P＜0.05).The area under the curve of rSIG index combined with serum FIB and CRP levels in predicting the prognosis of patients with multiple injuries was 0.972,which was significantly higher than that of single detection(all P＜0.05).The sensitivity of combined detection was 95.00％and the specificity was 88.33％.Conclusion The serum FIB level is decreased and CRP level is increased in patients with multiple injuries.The combination of FIB and CRP with rSIG index has certain predictive value for the prognosis of patients with multiple injuries.