Predictive Value Of NISS Scores Combined With Lac And TyG For Mortality In Nondiabetic Patients With Multiple Trauma

Objective: To explore the prediction of New severity score(NISS)combined with lactate(Lac)and Triglyceride Glucose index(Ty G)on mortality in non-diabetic multiple injuries(No-diabetic Multiple Injuries)patients value.Methods:The multiple injury patients admitted to the Emergency Center of the Second Affiliated Hospital of Anhui Medical University from November 2019 to November 2021 were collected.According to the inclusion and exclusion criteria,there were 147 cases of non diabetes multiple injury patients in this study.According to the treatment results after admission,they were divided into survival group(n=94 cases)and death group(n=53cases).Calculate the mortality of each group and analyze the statistical significance of the difference.Collect general data such as the patient’s sex,age,injury factors,injury site,heart rate,systolic blood pressure,diastolic blood pressure,body mass index(BMI),etc.,take blood gas(radial artery or femoral artery)after admission,take venous blood for blood routine test,first lactate,triglyceride,fasting blood glucose within 24 hours,and send samples for examination in time,and calculate Ty G value through LN[triglyceride(mg/dl)* plasma glucose(mg/dl)/2].SPSS 26.0 was used for statistical analysis.Analysis of variance was used for general data.Man-Whitney u test or Wilcoxon signed rank sum test were compared between the two groups;The independent risk factors were determined by binary logistic regression analysis.Graphpad prison drew a scatter plot and used receiver operating characteristic curve(ROC)to evaluate the level of NISS,Lac,Ty G and the predictive value of their combination on the mortality of non multiple injury diabetes patients.Results:1)The systolic blood pressure in the survival group was higher than that in the death group(Z=-2.941,P=0.003),and the shock index in the death group was higher(Z=7.616,P<0.001),with statistical significance(P<0.05).2)Analysis of variance showed that the difference of leukocyte count and triglyceride was not statistically significant(P>0.05),while the difference of hemoglobin(Z=-9.022,P=0.001),blood glucose(Z=-7.522,P=0.001)and lactic acid(Z=-2.996,P=0.03)was statistically significant(P<0.05).3)The binary logistic analysis showed that the NISS score(OR=0.961,95% CI:0.932-0.991,P=0.005),Ty G(OR=1.163,95% CI: 1.013-1.335,P=0.032),Lac(OR=2.134,95% CI: 1.119-4.070,P=0.035)had statistical significance for trauma patients(P<0.05).Shock,white blood cell count and hemoglobin had no significant difference in the death of trauma patients(P>0.05).4)The NISS scores of non diabetes multiple injury patients in the survival group were significantly lower than those in the death group(P<0.05),and the difference was statistically significant(P<0.05).The ROC showed that the area under the working characteristic curve(AUC)of the subjects tested by NISS,Lac,Ty G and combination were 0.705,0.684,0.720 and 0.834,respectively.Conclusion1)NISS score,Lac,Ty G are independent risk factors for early death of non diabetes patients with multiple injuries.2)This study shows that NISS score,Lac,Ty G are positively correlated with the mortality of non diabetes patients with multiple injuries.3)Non diabetes patients with multiple injuries develop rapidly and need early identification and treatment.These three markers are expected to provide a valuable way to explore the mechanism of multiple injuries.