The predictive value and prognostic analysis of platelet/lymphocyte ratio for traumatic coagulopathy
Objective To analyze the predictive and prognostic value of platelet-to-lymphocyte ratio(PLR)in traumatic coagulopathy(TIC).Methods The clinical data of patients with severe trauma admitted to the Department of Critical Care Medicine of Zhengzhou Central Hospital affiliated to Zhengzhou University from June 2021 to June 2023 were retrospectively analyzed.They were divided into TIC group and non-TIC group according to whether they were complicated with TIC or not,and into poor prognosis group and good prognosis group according to the discharge situation.The clinical data of the two groups were compared by single factor analysis,and the risk factors affecting the occurrence and prognosis of TIC patients were evaluated by multivariate Logistic regression analysis.Results A total of 298 patients were included,of which 82(27.5%)were TIC.The injury severity score(ISS),shock index(SI),temperature,PLR,hemoglobin,lymphocytes,lactic acid,alkali residue(BE),fibrinogen and D-dimer in TIC group were statistically significant different from those in non-TIC group(P<0.05).Multivariate logistic analysis showed that PLR,temperature,fibrinogen and BE were the risk factors of severe trauma with TIC(P<0.05).There were 23(28%)patients with poor prognosis in TIC group.The single factor analysis showed that Lymphocyte,PLR,SI,fibrinogen and D-dimer in TIC patients with poor prognosis group was significantly elevated(P<0.05).Multivariate logistic analysis showed that PLR and D-dimer were significant risk factors for poor prognosis of TIC patients(P<0.05).Receiver operating characteristic curve(ROC)analysis showed that the area under curve(AUC)of PLR in predicting severe trauma complicated with TIC was 0.821(95%CI:0.707～0.936).The sensitivity was 87%,and the specificity was 72.9%.The AUC of PLR in predicting the poor prognosis of TIC patients was 0.702(95%CI:0.633～0.771),with a sensitivity of 56.1%and a specificity of 77.8%.Conclusion Platelet-to-lymphocyte ratio has predictive value for the occurrence and prognosis of severe trauma complicated with traumatic coagulopathy.
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