Relationship between red cell distribution width/platelet count ratio and deep vein thrombosis in patients with severe traumatic brain injury during the perioperative period

CHEN Yutao; ZHANG Hui; HAN Haixia; HUO Xuning; LIU Xiujun; ZHANG Weimin

doi:10.3639/j.issn.1671-2897.2025.03.014

Abstract：Objective To explore the value of red cell distribution width(RDW)/platelet count(PLT)ratio(RPR)in the assessment of deep vein thrombosis(DVT)in patients with severe traumatic brain injury(sTBI)during the perioperative period.Methods A total of 116 patients with sTBI from June 2021 to June 2024 were retrospectively enrolled as the research subjects.Among them,24 patients with DVT during the perioperative period were assigned to the DVT group,and the remaining 92 patients with sTBI were assigned to the non-DVT group.The RDW and PLT of all sTBI patients at admission were recorded,and their RPR was calculated.The efficacy of RDW,PLT,and RPR in evaluating DVT in sTBI patients during the perioperative period was analyzed by ROC.The influencing factors of DVT in sTBI patients during the perioperative period were explored by Binary Logistic stepwise regression analysis.Results The levels of RDW and RPR in the DVT group were higher than those in the non-DVT group,whereas their PLT was lower(P<0.05).ROC results showed that the AUC(95%CI)of RDW,PLT,and RPR in evaluating DVT in sTBI patients during the perioperative period were 0.829(0.784-0.879),0.735(0.690-0.780),and 0.911(0.861-0.961)respectively.The AUC of RPR in evaluating DVT in sTBI patients during the perioperative period was superior to that of RDW and PLT(Z=8.429,P<0.01;Z=12.190,P<0.01).The DVT group had a higher proportion of patients with multiple injuries,injury-to-surgery time≥5 days,pulmonary infection,hyperglycemia,hypertension,and intraoperative blood loss,and a lower intraoperative blood transfusion volume than the non-DVT group(P<0.05).Injury-to-surgery time≥5 days(OR=2.408,95%CI:1.380-4.202),pulmonary infection(OR=1.865,95%CI:1.116-3.116),hyperglycemia(OR=2.109,95%CI:1.240-3.586),and RPR≥0.06(OR=3.304,95%CI:1.813-6.018)were the influencing factors of DVT in sTBI patients during the perioperative period(P<0.05).Conclusions The RPR value of patients with severe traumatic brain injury is closely related to the occurrence of deep vein thrombosis during the perioperative period,which is an important reference index for prognosis assessment and can provide a basis for clinical assessment.