The Early Predictive Value Of Neutrophil To Lymphocyte Ratio,Platelet And Albumin On The Severity And Prognosis Of Trauma Patients

Objective:To explore the early predictive value of neutrophil to lymphocyte ratio(NLR),platelet(PLT),albumin(ALB)for the severity and prognosis of trauma patients,and to provide help for clinical improvement of the success rate of trauma patients.Methods:A prospective research method was used to enroll trauma patients who were admitted to the emergency department of the First Affiliated Hospital of Dalian Medical University from January 2019 to December 2020(n=219).According to the injury severity score(ISS),it was divided into a minor injury group(ISS≤16,n=100)and a severe injury group(ISS>16,n=119).According to the 28-day survival situation,it was divided into the survival group(n=186))and the death group(n=33).Record the patients’ gender,age,and type of trauma.Collect 2ml,2ml and 3ml of the venous blood of the patient upon admission and send it to the Emergency Laboratory Department of the First Affiliated Hospital of Dalian Medical University for blood routine,coagulation,blood biochemistry(including myocardial markers,liver function,kidney function)tests,including white blood cell(WBC),neutrophil(N),lymphocyte(L),NLR,hemoglobin(HB),PLT,activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(Fib),creatine kinase MB(CK-MB),troponin I(Tn I),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIl),ALB,urea(Urea),creatinine(CRE).Calculate the patient’s ISS and observe the patient’s 28-day survival.The data of the two groups were compared by Mann-Whitney U test or Chi-square test.Binary logistic regression analysis was used to explore independent risk factors for trauma patients’ severity and prognosis,and receiver operating characteristic curve(ROC)was used to evaluate the value of meaningful indicators to predict the prognosis of trauma patients,and determined the best cut-off value.Results:1.There were statistically significant differences in WBC,N,L,NLR,HB,PLT,PT,Fib,CK-MB,Tn I,ALT,AST,TBIL,ALB,CRE between the minor injury group and the severe injury group.N,NLR,PT,CK-MB,Tn I,ALT,AST and CRE were all higher than those in the minor injury group(P<0.05),and the L,HB,PLT,Fib,TBIL and ALB in the severe injury group were all lower than those in the minor injury group(P<0.05).There was no significant difference in APTT and Urea between the minor injury group and the severe injury group(P>0.05).The results of binary logistic regression analysis showed that NLR and ALB were independent risk factors for the severity of trauma patients(P<0.05),NLR was positively correlated with the severity of trauma patients,and ALB was negatively correlated with the severity of trauma patients.2.There were statistically significant differences in ISS,WBC,N,L,NLR,HB,PLT,PT,Fib,CK-MB,Tn I,ALT,AST,ALB,Urea,CRE between the survival group and the death group.ISS,WBC,N,NLR,PT,CK-MB,Tn I,ALT,AST,Urea,CRE were all higher than those in the survival group(P<0.05),and the L,HB,PLT,Fib and ALB in the death group were all lower than survival group(P<0.05).There was no significant difference in APTT and TBIL between the survival group and the death group(P>0.05).The results of binary logistic regression analysis showed that NLR was an independent factor for the prognosis of trauma patients(P<0.05),and NLR was positively correlated with the poor prognosis of trauma patients.ROC curve analysis showed that the area under the curve(AUC)of NLR predicting the prognosis of trauma patients is 0.896,which is higher than other indicators such as ISS,ALB,PLT,etc.When the NLR cut-off value was 13.10,the sensitivity of NLR to predict the prognosis of trauma patients was 90.9% and the specificity was 75.8 %.Conclusions:1.The level of NLR within 24 hours after trauma is an independent risk factor for the severity and prognosis of trauma patients.The value of NLR in early predicting the prognosis of trauma patients is greater than other indicators such as ISS,ALB and PLT.2.The level of ALB within 24 hours after trauma is an independent risk factor for the severity of trauma patients.It is speculated that early correction of hypoproteinemia may be beneficial to improve the success rate of trauma patients.3.The level of PLT within 24 hours after trauma cannot predict the severity and prognosis of trauma patients.