Objectives: Venous thromboembolism is a highly prevalent condition after polytrauma, and recognized as an important factor contributing to poor prognosis. The aim of this study was to investigate the risk factors for lower extremity deep venous thrombosis (LEDVT) in a severely traumatized population and to evaluate their predictive value for LEDVT.
Methods: This was a retrospective, single-center observational study. All subjects were severely traumatized patients who were admitted to the Traumatic Intensive Care Unit from January 2021 to May 2024. Based on Doppler ultrasound findings of both lower extremities from the time of injury to 30 days post-injury, patients who developed LEDVT were enrolled in the LEDVT group, and those who did not develop LEDVT were enrolled in the NLEDVT group. Demographic, clinical, and laboratory data were collected upon admission. Multivariable logistic regression analysis was performed to identify risk factors for LEDVT. Receiver operating characteristic (ROC) curve was used to evaluate the overall fit of the final model.
Results: There were 56 patients enrolled in the LEDVT group and 81 patients in the NLEDVT group.Age, Aggregate Index of Systemic Inflammation (AISI), Systemic Inflammation Response Index (SIRI), ICU length of stay, and albumin were identified as independent risk factors for LEDVT (all P < 0.05). The area under their ROC curves were 0.604, 0.657, 0.694, 0.668, and 0.405, respectively. Combined model for early clinical prediction of LEDVT in severely traumatized patients by age, SIRI, AISI, and albumin resulted in an area under the ROC curve of 0.805 (95%CI: 0.73-0.88, SE = 0.037).
Conclusions: The combination of age, SIRI, AISI, and albumin has a predictive value for LEDVT in severely traumatized patients.
目的: 静脉血栓栓塞症是多发伤后常见的并发症之一，是导致患者预后不良的重要因素。本研究旨在探讨重症创伤患者发生下肢深静脉血栓（lower extremity deep venous thrombosis，LEDVT）的危险因素，并评估这些危险因素对LEDVT的预测价值。方法: 本研究为回顾性、单中心观察性研究。研究对象为2022年1月至2024年5月被收住于苏州大学附属第一医院创伤ICU的重症创伤患者。根据受伤至伤后30天内的超声检查结果，将发生LEDVT的患者纳入LEDVT组，未发生LEDVT的患者纳入NLEDVT组。入院时收集患者的人口学、临床和实验室检查数据。采用多因素逻辑回归识别LEDVT的危险因素，并利用受试者特征曲线（receiver operating characteristic，ROC）评估模型的整体拟合效果。结果: LEDVT组纳入56例患者，NLEDVT组纳入81例患者。年龄、全身炎症综合指数（Aggregate Index of Systemic Inflammation，AISI），系统炎症反应指数（Systemtic Immune Inflammation，SIRI），ICU住院时间及白蛋白是LEDVT的独立危险因素（P ＜ 0.05）。这些指标的ROC曲线下面积分别为0.604，0.657，0.694，0.668和0.405。综合分析年龄、SIRI、AISI及白蛋白对重症创伤患者发生LEDVT的预测效能，结果显示ROC曲线下面积为0.805（95%CI：0.73，0.88，P = 0.037）。结论: 综合年龄、SIRI、AISI和白蛋白的分析模型对重症创伤患者发生LEDVT具有预测价值。.
Keywords: Aggregate Index of Systemic Inflammation; Systemic Inflammation Response Index; Systemtic Immune Inflammation Index; lower extremity deep venous thrombosis; severe trauma.