A Nomogram Prediction Model for Clinical Outcome of Trauma-induced Coagulopathy Patients with Severe Multiple Trauma.

Abstract

Introduction: The objective of this study was to investigate the predictive value of thromboelastography (TEG) combined with conventional coagulation test parameters for the clinical outcome of patients with trauma-induced coagulopathy (TIC) and establish and evaluate a clinical nomogram for predicting the prognosis of TIC patients.

Methods: Clinical data of severe multiple trauma patients who underwent emergency treatment in the hospital from November 2018 to August 2021 were enrolled retrospectively. The prognosis was evaluated according to the length of hospital stay and the 30-day survival rate. Multivariable logistic regression model was used to evaluate the correlation between TEG parameters and clinical outcomes. A nomogram model was constructed and the receiver operating characteristic (ROC) curve was used to evaluate the predictive value.

Results: Univariate analysis indicated that there were significant differences in age, hypertension, temperature fluctuation (>3°C), transfusion, kinetics time (K), angle (α) value, maximal amplitude (MA), and international normalized ratio between the good and poor outcome group (P < 0.05). Multivariate logistic regression analysis showed that age, Glasgow Coma Scale scores, temperature fluctuation (>3°C), and MA parameters were independent risk factors for poor outcome, and we established the nomogram prediction model. According to ROC curve analysis, the area under the curve for MA parameter was 0.689 (95% confidence interval [CI]: 0.610-0.760), and the corresponding sensitivity and specificity were 44.12% and 91.87%, respectively. The area under the curve for temperature fluctuation (>3°C) was 0.697 (95% CI: 0.618-0.768), and the corresponding sensitivity and specificity were 60.00% and 79.67%, respectively.

Conclusion: TEG parameters combined with relevant clinical indicators can be used to evaluate the prognosis of TIC patients with severe multiple trauma. The establishment of correlation nomogram model was guiding significance for clinical evaluation of long-term prognosis of trauma patients.