Predictive Value Of The Reverse Shock Index Multiplied By Glasgow Coma Scale Score (rSIG) Coupled With D-dimer In Prognosis Of Patients With Multiple Trauma

ObjectiveTo compare the performance of the Reverse Shock Index Multiplied by Glasgow Coma Scale Score(rSIG)with Glasgow coma scale score(GCS)and modified early warning score(MEWS)in predicting the prognosis of patients with multiple trauma.To investigate the evaluation value of the rSIG and D-dimer in the prognosis of patients with multiple trauma.MethodsThe clinical data of 141 patients with multiple traumas admitted to the emergency room of our hospital from November 2019 to August 2020 were retrospectively analyzed.According to the treatment outcome at 28 days after injury the patients were divided into survival and death groups.Compare the differences between the three scoring groups,and generate receiver operating characteristic(ROC)curves for the three scorings to predict patient mortality.By comparing the area under the ROC curve to evaluate the predictive power of the three scores.SPSS 26.0 software was used for single-factor logistics analysis,and hematology test indicators that could predict the risk of death between groups were screened.Venous blood D-dimer was selected.The relationship between rSIG score and D dimer were analyzed.Receiver operating characteristic(ROC)curve analysis was performed to analyze the predictive value of rSIG and D dimer and the combination of the two on the prognosis of patients with multiple trauma.According to the best cut-off value of ROC curve analysis,the patients were divided into rSIG ≤7.75 group and rSIG>7.75 group,D dimer ≤ 20.6 mg/L group and D dimer> 20.6 mg/L group.Compare the statistical significance of the difference in mortality between the groups.ResultsOne hundred and forty one patients were included.The rSIG score of the survival group was higher than that of the death group [18.1(±7.8)VS 15.5(±10.6),P=0.216],while the GCS score was higher than that of the death group[12.19(±3.5)VS 6.1(±4.2),P<0.001].The MEWS score of the survival group was lower than that of the death group [2.56(±1.74)VS 5.0(±2.45),P<0.001].The area under the ROC curve of the GCS score was larger than the MEWS score and rSIG score(Z values were 1.767 and 2.876,both P<0.001),and the difference was statistically significant.The area under the ROC curve of MEWS score was larger than rSIG score(Z=1.750,P=0.08),and the difference was not statistically significant.D dimer is lower than the death group [(11.3±10.2)VS(26.4±10.4)],the difference was statistically significant(t=-4.75,P<0.05).D-dimer is better than rSIG in judging the prognosis of patients with multiple trauma,and the difference is statistically significant(Z=2.527,P<0.05).D-dimer is also better than rSIG and Ddimer in combination,but there is no difference statistically significant(Z=0.158,P=0.8747),rSIG and D-dimer combined judgment ability is better than rSIG,the difference is statistically significant(Z=2.76,P<0.05).The 28-day mortality rate of patients in the rSIG ≤ 7.75 group was greater than that in the rSIG >7.75 group,and the difference was statistically significant(c2=8.346,P<0.05).The 28-day mortality rate of the D dimer ≤ 20.6 mg/L group was lower than that of the D dimer> 20.6 mg/L group,the difference was statistically significant(c2=30.157,P<0.05).The patient’s rSIG was negatively correlated with D dimer(r=-0.046,P=0.592).ConclusionAll three scores have predictive value for the prognosis of patients with multiple traumas.GCS score has the best predictive performance,MEWS score is second,and rSIG score is the worst.D-dimer level is related to the mortality of patients with multiple traumas,and its predictive ability is better than rSIG and the combination of the two,and they also have certain guiding significance in clinical treatment.