Study on the Predictive Value of ISS Score,Shock Index Combined with Serum Syndecan-1 and VWF at Admission for Traumatic Coagulopathy Disease in Patients with Multiple Trauma
Objective:To study the predictive value of injury severity score(ISS),shock index combined with serum multiligand proteoglycan-1(Syndecan-1)and von Willebrand factor(VWF)at admission for traumatic coagulopathy disease(TIC)in patients with multiple trauma.Methods:200 patients with multiple trauma who were treated in Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2019 to December 2022 were selected.Patients were divided into TIC group(61 cases)and non-TIC(NTIC)group(139 cases)according to whether TIC occurred.The ISS score,shock index,serum Syndecan-1 and VWF levels at admission were compared in two groups,the influencing factors of TIC in patients with multiple trauma were analyzed by univariate and multivariate Logistic regression,the predictive value of ISS score,shock index,serum Syndecan-1 and VWF on TIC in patients with multiple trauma were analyzed by receiver operating characteristic(ROC)curve.Results:Among the 200 patients,a total of 61 patients with TIC occurred,with an incidence of 30.50％.The ISS score,shock index,Syndecan-1 and VWF levels in TIC group were higher than those in NTIC group(P＜0.05).Multivariate Logistic regression analysis showed that,hypothermia,acidosis,Glasgow Coma Score(GCS)＜6 points,complicated severe craniocerebral injury,increased ISS score at admission,increased shock index,increased serum Syndecan-1 and increased VWF were risk factors for TIC in patients with multiple trauma.ROC curve analysis showed that the combined application of ISS score,shock index,serum Syndecan-1 and VWF had the highest predictive value for TIC at admission,the area under the curve(AUC)was 0.849,the sensitivity was 0.918 and the specificity was 0.755,all of which were better than the individual prediction.Conclusion:The increase of ISS score,shock index,serum Syndecan-1 and VWF at admission arc relate to the incidence of TIC in patients with multiple trauma.Hypothermia,acidosis,GCS＜6 points,complicated severe craniocerebral injury,increase ISS score at admission,increase shock index are risk factors for TIC in patients with multiple trauma.ISS score,shock index combined with serum Syndecan-1 and VWF detection have high predictive value at admission for TIC in patients with multiple trauma.
Injury severity scoreShock indexSyndecan-1VWFMultiple traumaTraumatic coagulopathy diseasePredictive value
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