Analysis Of Prognostic Factors Of Acute Respiratory Distress Syndrome Secondary To Multiple Injuries

Objectives To explore the prognostic factors in patients with ARDS secondary to multiple trauma and provide reference for clinical evaluation of patients’ condition.Methods In strict accordance with the inclusion and exclusion criteria,156 cases of acute respiratory distress syndrome were collected from June 2014 to June 2017 in the affiliated hospital of North China University of Science and Technology.Depending on whether the patient died within 3 months after the trauma,those cases divided into death group 54 cases,survival group 102 cases.Collecting the results of the patient’s laboratory examination,such as:(1)index of inflammatory: WBC,hs-CRP,PCT;(2)index of liver function: ALT,AST,ALB,TC,TG;(3)index of renal function: SCr,BUN;(4)index of coagulation function: PLT,D-D,PT.Data of 2th days,7th days,and 14 th days after trauma were collected.The data collected were statistically analyzed and the differences between the two groups were compared.P≤0.05 that the difference was statistically significant.All the indexes were analyzed by Logistic regression analysis to screen the factors of death in patients with acute respiratory distress syndrome after multiple trauma.The ROC is plotted and the predictive value of the related factors is analyzed.Results 1 Results of Logistic regression analysis:(1)2th day: ALT(OR=51.983,P<0.001),AST(OR=3.320,P=0.002),SCr(OR=2.380,P=0.016),D-D(OR=2.696,P=0.012),and PT(OR=2.079,P=0.045)were the risk factors of patients’ death;(2)7th day: PCT(OR=8.714,P=0.011),ALT(OR=66.536,P=0.002),AST(OR=41.513,P=0.003)were the risk factors of patients’ death;PLT(OR=0.122,P=0.008)was a protective factor of patients’ death;(3)14th day: hs-CRP(OR=5.220,P=0.004),PCT(OR=13.034,P=0.002)were the risk factors of patients’ death,ALB(OR=0.247,P=0.008),PLT(OR=0.406,P=0.035)were protective factor of patients’ death.2 The results of ROC curve analysis show that for the death of the patient,ALT has the highest forecast value on 2th day and 7th day(AUC=0.956,0.955);PCT has the highest forecast value on 14 th day(AUC=0.945).Conclusions 1 hs-CRP,PCT,ALT,AST,SCr,D-D,PT were the risk factors of patients’ death,ALB,PLT were protective factor of patients’ death.2 ALT showed highest predictive value for patients’ death on the 2th day and 7th day after injury,PCT showed highest predictive value for patients’ death on the 14 th day after injury.3 The intensity of the correlation between factors and death are different at different time points,the predictive value of various factors on death are different at different time points.It is of important clinical significance to observe the related indexes dynamically.