Analysis Of Risk Factors For Early Death Of Patients With Multiple Trauma In Emergency Room

Objective Through retrospective analysis of the clinical data of patients with multiple injuries admitted to the emergency room of our hospital,and statistical analysis to explore its impact on the early death of patients with multiple injuries and its predictive valueMethods The clinical data and initial serum biological indicators(blood gas,blood routine,blood sugar,coagulation,etc.)of patients with multiple trauma admitted to the emergency room of our hospital from January 1,2018 to December 31,2019 were collected.The patients were divided into survival group(948 cases)and death group(92 cases)according to whether they died early after injury(≤24 hours),and the clinical characteristics of early death of patients with multiple trauma were analyzed descriptively.Single factor and multivariate logistics regression were used to analyze the independent risk factors for early death of patients with multiple trauma,and the ROC curve was further drawn to analyze its prognostic value for early death of multiple trauma Results 1.A total of 1040 patients with multiple injuries were included in the study,92 early deaths,and the early mortality rate was 8.85%.The main trauma mechanism is car accidents(64.71%),more than 1-6 hours(62.98%)after the injury to see a doctor,≤1 hour death accounted for 33.70%,1-6 hours death 52.17%.2.Univariate analysis results show: Glasgow score(GCS),falls,head injury,1 hour admission,initial blood oxygen saturation,respiration,mean arterial pressure(MAP),systolic blood pressure,severe injury score(ISS),PH value,lactate value,white blood cell count,neutrophil to lymphocyte ratio(NLR),blood glucose,prothrombin time(PT),activated partial prothrombin time(APTT),international standard ratio(INR),fibrinogen(FIB)have statistically significant differences in early death and survival in patients with multiple injuries(P<0.05).3.Multivariate logistic regression analysis found that GCS score,NLR,blood glucose,lactic acid,blood oxygen saturation,INR and admission 1 hour after injury were independent risk factors for early death from multiple injuries,and the OR values were 0.697,0.936,and 1.073,1.131,0.951,3.105,and 0.315.4.Multivariate analysis showed that blood oxygen saturation,GCS score,NLR,blood glucose,lactate,INR,1 hour post-injury admission and the combined predictive index to draw the ROC curve(AUC)were respectively 0.749,0.886,0.758,0.798,0.771,0.787,0.619 and0.947,the corresponding cut-off values are: 91%,9 points,7.85,10.7mmol/L,4.6mmol/L,1.22;the combined index is compared with other parameters The predictive value of early death is the highest,which is statistically significant(P<0.05).Conclusion 1.GCS score,initial blood oxygen saturation,blood glucose,lactate,neutrophil to lymphocyte ratio(NLR),INR and admission within 1 hour after injury have predictive value for early death of patients with multiple trauma in the emergency room.2.NLR has a predictive effect on the early death of patients with multiple trauma in the emergency room.