【Objective】 To investigate the correlation between D-dimer, serum potassium and thromboelastography parameters and progressive hemorrhagic injury (PHI) after brain injury. 【Methods】 The data of 209 patients with traumatic brain injury (TBI) in our hospital from January 2018 to May 2021 were collected and analyzed. The patients were divided into PHI group (161 cases) and non-PHI group (48 cases) according to CT scan whether the total bleeding lesions had increased by 25%. Univariate analysis and multivariate Logistic regression were used to analyze the risk factors of PHI, and receiver operating curve (ROC) was used to analyze the predictive value of D-dimer, serum potassium and thromboelastography (TEG) parameters used alone and in combination. 【Results】 PHI occurred in 48 (23.0 %) out of 209 TBI patients. In univariate analysis, there were statistically significant differences in GCS score, age, light emission, systolic blood pressure, serum potassium, blood calcium, blood glucose, R value, PT, APTT, INR, D-dimer, arachnoid hemorrhage, subdural hematoma, cerebral contusion and midline location between the two groups (P<0.05). Five independent risk factors were determined by multivariate Logistic analysis (P<0.05): D-dimer ≥3.52 μg/mL, serum potassium <3.70 mmol/L, R value ≥5.65 min, subdural hematoma and cerebral contusion. PHI model was constructed according to independent risk factors, and the maximum area under the curve (AUC) of D-dimer plus serum potassium plus R value plus subdural hematoma plus cerebral contusion was 0.889 9. 【Conclusion】 D-dimer ≥3.52 μg/mL, serum potassium <3.70 mmol/L, R value ≥5.65 min, subdural hematoma and cerebral contusion are significant influences for PHI occurrance in TBI patients.

Objective: To retrospectively analyze the early monitoring indicators before and after admission, the use of coagulation/anticoagulant medications, and the red blood cell transfusion within 24 hours in emergency trauma patients, and to identify the indicators related to the volume of red blood cells transfused during the first 24 hours of hopitalization, thereby assisting clinical judgment of the probability and required quantity of red blood cell transfusion. Methods: Data of 117 emergency trauma patients admitted to intensive care unit (ICU) from January 2022 to March 2024 were retrospectively analyzed. Patients were categorized according to whether the volume of red blood cells transfused within 24 hours exceeded specific quartile thresholds (Q1, Q2, Q3). Non-parametric tests were used for numerical variables and Chi-square tests were used for categorical variables to identify statistically significant single-factor indicators, which were subsequently incoporated into a binary logistic regression model to obtain a combined predictive probability. ROC curve analysis was performed on the multi-factor indicators and their combined predictive probability derived from the binary logistic regression model. Results: 1) The initial hemoglobin (Hb) and hematocrit (Hct) levle were independent influencing factors in the group with red blood cell transfusion volume exceeded Q1 (P<0.05), and the combined predictive probability demostrated by ROC curve analysis was AUC=0.858 (P<0.05). 2) In the group of red blood cell transfusion volume exceeding Q2, the initial Fib, transhulitic acid, human prothrombin complex, trauma category and primary trauma site were independent influencing factors (P<0.05), and the combined predictive probability of ROC curve analysis was AUC=0.966 (P<0.05). 3) Pulse pressure and trauma category were independent influencing factors in the group with red blood cell transfusion volume exceeding Q3 (P<0.05), and ROC curve analysis revealed that combined prediction probability was AUC=0.944 (P<0.05). Conclusion: Early monitoring indicators and the use of coagulation medications, before and after admission in emergency trauma patients show diagnostic value in predicting the amount of red blood cells transfused on the first day of admission. Early warning alerts established through patient monitoring indicators can reduce incidents of untimely blood supply from the blood transfusion department (blood bank) for emergency trauma patients with massive hemorrhage, especially for patients with rare blood types or during blood supply shortage.