Predictive value of serum t-PAIC and TM for acute traumatic coagulopathy in patients with severe traumatic brain injury
LI Yonghai
YANG Xiaoman
WANG Xincun
ZHANG Junming
WANG Nannan
Abstract：Objective To explore the predictive value of serum tissue plasminogen activator inhibitory complex(t-PAIC)and thrombomodulin(TM)for acute traumatic coagulopathy(ATC)in patients with severe traumatic brain injury(sTBI).Methods A total of 120 patients with sTBI from January 2021 to January 2024 were selected(study group).According to the presence or absence of ATC,the study group was divided into non-ATC group(n=89)and ATC group(n=31),and another 100 healthy people were selected as the control group.Enzyme-linked immunosorbent assay was used to measure and compare the serum t-PAIC and TM between the study group and the control group,non-ATC group and ATC group.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum t-PAIC and TM for ATC in patients with sTBI.The influencing factors of ATC in patients with sTBI were explored by multivariate Logistic stepwise regression analysis.Results The levels of t-PAIC and TM in the study group were higher than the control group(P<0.05).The levels of t-PAIC and TM in sTBI patients in ATC group were higher than those in sTBI patients in non-ATC group(all P<0.05).The AUC of serum t-PAIC and TM in predicting ATC in sTBI patients was 0.793(95%CI:0.743-0.838),0.846(95%CI:0.796-0.891),and the AUC of the combination of the two was 0.908(95%CI:0.863-0.958).Univariate results showed that the GCS score and arterial blood pH of patients in ATC group were significantly lower than those in non-ATC group,and the proportion of patients with shock and subarachnoid hemorrhage was significantly higher than that in non-ATC group(all P<0.05).Multivariate analysis showed that GCS score at admission 4.68(OR=2.261,95%CI:1.405-3.641),arterial pH≤6.04(OR=2.098,95%CI:1.248-3.527),t-PAIC≥21.48 ng/mL(OR=2.826,95%CI:1.808-4.419),TM≥27.41 TU/mL(OR=2.575,95%CI:1.637-4.050)were the independent risk factors for ATC in sTBI patients(P<0.05).Conclusions The occurrence of ATC in patients with sTBI is closely related to the increase of serum t-PAIC and TM.Serum t-PAIC and TM have certain predictive value for the occurrence of ATC in patients with sTBI,and the prediction efficiency of the combination of the two detection methods is better.
Keywords：t-PAICThrombomodulinSevere craniocerebral injuryAcute traumatic coagulopathyPredicting
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 58-63 )