Predictive value of age-adjusted rSIG index and international normalized ratio for the outcome of elderly patients with severe trauma
Objective To explore the predictive value of age-adjusted reverse shock index multipliedby Glasgow Coma Scale divided by age (rSIG/A) and international normalized ratio (INR) for the outcome of elderly patients with severe trauma. Methods A retrospective selection of 238 elderly patients with severe trauma admitted to Department of Emergency Medicine in Lishui People's Hospital from January 2021 to December 2023 was conducted. According to the prognosis,201 patients were assigned to the survival group and 37 patients to the death group,and the clinical data of the two groups were compared. ROC curves were used to assess the efficacy of rSIG/A and INR alone,and the combination of both on predicting the outcome of elderly patients with severe trauma. Multivariate logistic regression was used to analyze the prognosis of elderly patients with severe trauma. Grouped by the optimal cut-off values of rSIG/A and INR,the differences in mortality between groups were compared. Results There were significant differences in INR and rSIG/A between the survival group and the death group (both P<0.05). ROC curve analysis showed that the AUCs of rSIG/A and INR alone,and the combination of both in predicting the prognosis of elderly patients with severe trauma were 0.826,0.732 and 0.846,respectively;the optimal cut-off values of rSIG/A and INR for predicting their outcome were 0.26 and 1.20,respectively. The mortality rate of patients in the high rSIG/A group (rSIG/A>0.26) was lower than that in the low rSIG/A group (rSIG/A≤0.26),and the difference was statistically significant (P<0.05). The mortality rate of patients in the high INR group (INR≥1.20) was higher than that of the low INR group (INR<1.20),and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that low rSIG/A (OR=6.689) and high INR (OR=3.205) were independent risk factors affecting the prognosis of elderly patients with severe trauma (both P<0.05). Conclusion rSIG/A and INR have high predictive value for the prognosis of elderly patients with severe trauma,and the combination of the two can better predict the risk of death in elderly patients with severe trauma.