Risk factors for trauma-induced coagulopathy in patients with splenic rupture following sur-gical management
Objective To explore the risk factors of trauma-induced coagulopathy(TIC)in patients with splenic rupture following surgical treatment.Methods A retrospective analysis was conducted on 84 patients who underwent surgical treatment for traumatic splenic rupture in the emergency department of the Second Affiliated Hos-pital of Anhui Medical University from Jan.2017 to Dec.2021,including 52 males and 32 females aged 18-82 years,with the average age of 50.1 years.There were 37 cases of road traffic injuries,21 falls from height,15 ground-level falls,and 11 assault injuries.Patients were divided into TIC group(n=30)and non-TIC group(n=54)based on whether they were combined with TIC.For both groups,gender,age,injury time,shock index,initial tem-perature on admission,ISS,and first test results after admission for hemoglobin,hematocrit,platelet count,C-reactive protein(CRP),liver function(alanine aminotransferase),nutritional status(albumin),pH value,base excess(BE),lactate,international normalized ratio,D-D dimer,activated partial thromboplastin time(APTT),thrombin time(TT),plasma fibrinogen(FIB),and blood loss were analyzed using the univariate analysis.The variables showing statistically significant difference were selected for multivariate logistic regression analysis.Results The variables of age,hemoglobin,hematocrit,D-D dimer,blood loss,initial temperature CRP,alanine aminotransferase and albumin on admission revealed no significant difference(all P＞0.05),whereas the shock index,platelet count,injury time,ISS,pH value,BE,lactate,APTT,TT,FIB showed statistically significant differences between the two groups(all P＜0.05).Multivariate regression analysis further revealed that shock index(OR=2.355,95％CI 1.318-3.948),platelet count(OR=0.987,95％CI 0.970-1.004),and FIB(OR=0.599,95％CI 0.180-0.972)were significantly correlated with the incidence of TIC(all P＜0.05).Conclusion For trauma patients with splen-ic rupture,the shock index,platelet count,and FIB are independent risk factors for developing DIC after surgical management.
万方数据
维普
