Clinical Significance Of Thromboelastography In The Prognosis Of Emergency Patients With Multiple Injuries

Objective: To study the clinical significance of thromboelastography(TEG)in the prognosis of emergency patients with multiple injuries.Methods: A retrospective case-control study was conducted to analyze 120 patients with emergency multiple injuries treated in the first affiliated Hospital of Xinjiang Medical University from January 2019 to September 2020.According to the outcome of 90 days after injury,the patients were divided into survival group(n = 90)and death group(n = 30).The age,sex,vital signs on admission,site of trauma,cause of injury,injury severity score(ISS),acute physiology and chronic health assessment Ⅱ(APACHE Ⅱ),Glasgow coma score(GCS),trauma and injury severity score(TRISS),modified early warning score(MEWS)and 90-day outcome were collected.Platelet count(PLT),hemoglobin(Hb),hematocrit,plasma prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),fibrin degradation product(FDP),D-dimer(D-D)and TEG clotting reaction time(R),clot formation rate(K),clot formation kinetics(α angle),The maximum strength of blood clot,(MA),etc.Results: Compared with the survival group,ISS,TRISS,APACHEII,respiratory rate,mechanical ventilation time,tracheotomy rate,incidence of cardiopulmonary resuscitation and complications were significantly increased,GCS was significantly decreased,PT and APTT were significantly prolonged,FDP was significantly increased,PLT,FIB and hematocrit were significantly decreased in the death group.Compared with the survival group,the α angle of the death group was significantly lower and the R value was significantly higher than that of the survival group(P < 0.05).There was no significant difference in D-D,K and MA between the two groups.Logistic regression analysis showed that R value(OR=4.353,P < 0.05)was significantly correlated with the prognosis of emergency patients with multiple injuries.The area under ROC curve of R was 0.737.When the R boundary value is 4.45 min,the sensitivity and specificity are 86.7% and 60%,respectively.Conclusion: TEG index R is helpful to judge the prognosis of emergency patients with multiple injuries,and the mortality of emergency patients with multiple injuries will be significantly increased when R >4.45 min.