Predictive value of neutrophil-to-lymphocyte ratio combined with D-dimer and injury severity score on prognosis of patients with multiple injuries
Objective To explore the predictive value of early neutrophil-to-lymphocyte ratio(NLR)and D-dimer(early stage of hospitalization),injury severity score(ISS)and their combination on the prognosis of pa-tients with multiple trauma.Methods This retrospective analysis was conducted on data of 198 adult patients with multiple trauma admitted to our hospital from Jan.2022 to Dec.2023,including 137 males and 61 females aged 18-86(mean 56.5)years.Based on the 28-d outcomes,patients were divided into non-survival group(n=55)and survival groups(n=143).General data(gender,age,injury site,and injury severity),routine laboratory tests(white blood cell count,neutrophil count,lymphocyte count,platelet count,hemoglobin,NLR,and D-dimer),and ISS were collected for all patients.The predictive value of these factors for the prognosis of patients with multiple trauma was analyzed using logistic regression analysis and ROC curve analysis.Results Among the factors analyzed,lympho-cyte count,hemoglobin,NLR,D-dimer,and ISS showed significant differences between the two groups(all P<0.05),while the others showed no significant differences(all P>0.05).Logistic regression analysis identified NLR,D-di-mer,and ISS as independent factors affecting the prognosis of patients with multiple trauma.ROC analysis showed that the area under the curve(AUC)was 0.818(95%CI:0.757-0.869)for NLR,0.787(95%CI:0.724-0.842)for D-dimer,and 0.734(95%CI:0.667-0.795)for ISS,with no significant differences between any of the three factors(D-dimer vs.ISS,P=0.350;D-dimer vs.NLR,P=0.490;ISS vs.NLR,P=0.170).The combined use of the three factors showed an AUC of 0.883(95%CI:0.841-0.932),significantly higher than any factors alone(all P<0.05).Conclusion In the early stages of hospitalization,the NLR,D-dimer,and ISS can help predict the outcome of patients with severe multiple injuries,especially when they were used combinedly.
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