Clinical Significance Of SII And VWF Factor Combined With TTS Scores In Chest Trauma

Objective:The systemic immune-inflammatory index(SII)was calculated by detecting the change trend of von willebrand factor(VWF),neutrophil granulocyte(NE),lymphocyte(LYM)and platelet(PLT)in plasma of patients with chest trauma of different severity,At the same time,the severity of chest trauma patients was graded according to the thoracic trauma severity score(TTS).To study the correlation between the above biological indicators and TTS score in patients with chest trauma,and to explore its role in the prediction of patients’ condition and prognosis evaluation at the early stage of injury.Methods:Select the patients who were definitely diagnosed as chest trauma in our hospital from November 2021 to December 2022,and the inclusion criteria are as follows: 1.Admission within 24 hours after trauma;2.Chest trauma was diagnosed according to physical examination,medical history and auxiliary examination;3.Hospitalization time>7 days;4.Age ≥ 18 years old;Exclusion criteria: 1.Chronic hematological diseases(leukemia,MDS,etc.);2.Patients undergoing radiotherapy and chemotherapy;three Splenectomy patients;4.Patients with incomplete data.A total of 41 cases were included in the study,including 27 males and 14 females;Age: 35-85 years old(56.73 ±12.13 years old);According to the TTS scoring standard,the subjects were divided into two groups: Mild trauma group(Group A)n=25;severe trauma group(Group B)n=16,including the number of deaths after treatment n=8.Collect the general clinical data of patients and the chest trauma severity score(TTS)within 24 hours after admission.VWF,NE,LYM and PLT in venous blood were measured on the first,third and seventh days after the patient was admitted to hospital,and SII values were calculated,the change trend of the above indicators was observed,and all collected data were statistically analyzed.All experimental data were analyzed with statistical software SPSS26.0.The counting data was expressed in cases(n,%).The constituent ratio and percentage of chi-square test(2 test)were compared;For the comparison of measurement data,if the data conforms to the normal distribution,the mean ± standard deviation(X ± SD)shall be used to express,and the independent sample t-test shall be used to compare the data between two groups,and the single-factor analysis of variance shall be used to compare the data between multiple groups(more than two groups);The prediction probability was analyzed by binary logistic regression.In order to evaluate the correlation between the change trend of the above indicators and patients with different degrees of chest trauma,the best threshold,sensitivity,specificity,positive predictive value,negative predictive value and area under the curve(AUC)of different indicators were analyzed by the subject’s working characteristic curve(ROC curve),and the difference was statistically significant with P<0.05.Results:1.At the three time points of 1 day,3 days and 7 days,the level of SII in Group A showed a downward trend,while the level of SII in Group B showed an upward trend,and the level of SII in Group B was significantly higher than that in Group A at the three time points(P<0.05)2.At the three time points of 1d,3d and 7d,the level of VWF in Group A increased first and then decreased,while the level of VWF in Group B increased,and the level of VWF in Group B was significantly higher than that in Group A at the two time points of 3d and 7d(P<0.05).3.Statistical analysis showed that VWF(3d),VWF(7d)and TTS scores were significantly correlated with different prognosis of patients with chest trauma(P<0.05).4.When VWF(7d)and TTS were jointly diagnosed,the AUC area was the largest,AUC=0.847,which confirmed that the combined diagnosis of VWF(7d)and TTS had the greatest clinical significance(P<0.05).Conclusions:1.This study shows that the expression of SII and VWF is related to the severity of chest trauma patients.The higher the expression level is,the more severe the trauma is,indicating that the changes of the above factors can reflect the severity of chest trauma patients.2.VWF(7d)combined with TTS score has the highest predictive value for different prognostic outcomes in patients with thoracic trauma(AUC=0.847).