Analysis of the maximum amplitude of thromboelastogram to evaluate the prognosis of patients with severe trauma and its influencing factors
Objective To study the effect of TEG maximum amplitude(MA)in evaluating the prognosis of patients with severe trauma and analyze the influencing factors.Methods From July 2020 to July 2023,112 patients with severe trauma with injury severity score(ISS)≥16 in the emergency department and ICU of our hospital were recruited.The patients were divided into MA≥50 mm group(71 cases)and MA<50 mm group(41 cases).The thrombine-antithrombin complex(TAT),tissue plasminogen activator-plasminogen activator inhibitor-1 complex(tPAIC),plasminogen α2 plasminogen inhibitor complex(PIC),fibrinogen(FIB),platelet(PLT)count,ISS score,gender and age were statistically analyzed in two groups of patients.ROC curve analysis for survival was performed by MA and PLT..Results Compared with MA≥50 mm group,TAT,PIC,t-PAIC and ISS scores in MA<50mm group were significantly increased(P<0.05 or P<0.01).The FIB and PLT counts were significantly decreased(P<0.01).Correlation analysis results showed that MA was correlated with tPAIC,TAT,PLT count and ISS score(P<0.05),and was highly correlated with PIC and FIB(0.4<r<0.7,P<0.05).The 28-day mortality of severe trauma patients in MA≥50 mm group(26.73%)was significantly lower than that in PLT≥100×109/L group(44.44%)(P<0.05).The 28-day mortality of severe trauma patients in MA<50 mm group(75.61%)was significantly higher than that in PLT<100×109/L group(45.00%)(P<0.01).The ROC curve showed that the area under the curve(AUC)of MA in predicting the survival rate of patients with severe trauma was 0.776,which was significantly higher than the AUC of PLT count in predicting the survival rate of patients with severe trauma(0.563).Conclusion Compared with PLT count,MA of TEG is more accurate in predicting the prognosis of patients with severe trauma,and is related to the relevant indicators reflecting the degree of trauma,hyperfibrinolysis and thrombin production capacity.
ISS scoreSevere traumaPlatelet functionHyperfibrinolysisThrombin
NETL
NSTL
万方数据
维普
