Analysis of the predictive value of the product index of reverse shock index and Glasgow coma scale score combined with serum indicators for the prognosis of patients with multiple trauma combined with multiple organ dysfunction syndrome

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

doi:10.3760/j.issn.1673-4777.2024.10.014

Abstract：Objective To investigate the prognostic value of the product of reverse shock index and Glasgow coma scale(rSIG)index combined with serum D-dimer,fibrinogen and C-reactive protein in multiple trauma patients with multiple organ dysfunction syndrome(MODS).Methods A total of 194 patients with multiple trauma treated in the Emergency Treatment Room,North China University of Science and Technology Affiliated Hospital from January 2020 to January 2022 were selected as the research objects.According to the presence or absence of MODS during treatment,they were divided into non-MODS group(98 cases)and MODS group(96 cases).The MODS group was further divided into survival group(52 cases)and death group(44 cases)according to the survival situation of patients at 28 d after injury.The levels of serum D-dimer,fibrinogen,C-reactive protein and rSIG index were compared among the groups.Multivariate Logistic regression was used to analyze the influencing factors of the prognosis of multiple trauma patients with MODS.Receiver operating characteristic(ROC)curve was used to analyze the value of rSIG index combined with serum D-dimer,fibrinogen and C-reactive protein in predicting the prognosis of multiple trauma patients with MODS.Results The levels of serum D-dimer,fibrinogen and C-reactive protein in MODS group were higher than those in non-MODS group[(14±3)mg/L vs(9±3)mg/L,(4.5±1.0)g/L vs(3.0±1.0)g/L,(32±6)mg/L vs(21±6)mg/L](t=10.352,10.079,12.883;all P＜0.001).The levels of serum D-dimer,fibrinogen,and C-reactive protein in the death group were significantly higher than those in the survival group,and the rSIG index was significantly lower than that in the survival group(all P＜0.001).Multivariate Logistic regression analysis showed that D-dimer,fibrinogen,C-reactive protein and rSIG index were independent prognostic factors for multiple trauma patients with MODS(all P＜0.05).ROC curve analysis showed that the area under the curve of D-dimer,fibrinogen,C-reactive protein,and rSIG index combined detection to predict the prognosis of multiple trauma patients with MODS was 0.964,the sensitivity was 84.09％,and the specificity was 96.15％,which was better than that of each index alone(all P＜0.05).Conclusion The serum D-dimer,fibrinogen,and C-reactive protein of patients in the death group of multiple trauma combined with MODS increased significantly,and the rSIG index decreased significantly.The combination of the above indicators has a good predictive value for the prognosis of patients with multiple trauma combined with MODS.