Correlation between D-dimer, antithrombin Ⅲ levels and multiple organ dysfunction syndrome in patients with severe multiple trauma
10.3760/cma.j.cn115455-20240912-00792
- VernacularTitle:D-二聚体、抗凝血酶Ⅲ水平与严重多发伤患者多器官功能障碍综合征的相关性
- Author:
Kang TOU
1
;
Laifa KONG
;
Zhi WANG
;
Yong′an XU
Author Information
1. 金华市中心医院创伤外科，金华 321000
- Publication Type:Journal Article
- Keywords:
Wounds and injuries;
Severe multiple injuries;
Multiple organ dysfunction syndrome;
D-dimer;
Antithrombin Ⅲ
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(7):577-584
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the correlation between D-dimer (D-D), antithrombin Ⅲ (AT-Ⅲ) at admission, and multiple organ dysfunction syndrome (MODS) in patients with severe multiple trauma.Methods:A retrospective study was conducted to collect data from 80 patients with severe multiple trauma admitted to Jinhua Central Hospital from April 2021 to April 2024. According to the occurrence of MODS within 1 week of treatment, the patients were divided into an occurrence group with 25 cases and a non-occurrence group with 55 cases. The general data, plasma D-D, serum AT-Ⅲ levels and other laboratory indexes at admission were compared between the two groups. The correlation between D-D, AT-Ⅲ at admission and MODS in patients with severe multiple trauma was analyzed.Results:The injury severity rating score (ISS) in the occurrence group was higher than that in the non-occurrence group: (29.12 ± 3.84) points vs. (26.18 ± 3.12) points, the proportion of damage control surgery was lower than that in the non-occurrence group: 32.00% (8/25) vs. 65.45% (36/55), the platelet, AT-Ⅲ and albumin at admission were lower than those in the non-occurrence group: (112.28 ± 20.12) ×10 9/L vs. (123.56 ± 23.47) ×10 9/L, (133.79 ± 18.21) mg/L vs. (148.26 ± 19.57) mg/L, (35.12 ± 6.35) g/L vs. (38.47 ± 5.88) g/L, the D-D at admission was higher than that in the non-occurrence group: (11.36 ± 3.35) mg/L vs. (8.18 ± 2.83) mg/L, and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis result showed that the occurrence of MODS in patients with severe multiple trauma may be related to the ISS at admission, the status of receiving damage control surgery, and the D-D, AT-Ⅲ, albumin at admission ( OR = 1.29, 0.14, 1.34, 0.95 and 0.87; P<0.05). Restrictive cubic spline analysis showed that the risk of MODS in patients with severe multiple trauma showed a non-linear dose-response relationship with D-D and AT-Ⅲ at admission ( P<0.05). When D-D at admission ≥ 9.25 mg/L, the risk of MODS increased with increasing levels, while when AT-Ⅲ at admission ≤ 143.49 mg/L, the risk of MODS increased with decreasing levels. The D-D and AT-Ⅲ at admission had a negative interactive effect on the occurrence of MODS in patients with severe multiple trauma. By drawing decision curves and column charts, it was found that D-D and AT-Ⅲ at admission, as well as other major indicators, had high predictive power for the occurrence of MODS in patients with severe multiple trauma. Conclusions:The occurrence of MODS in patients with severe multiple trauma may be related to the levels of D-D and AT-Ⅲ, and the risk of MODS increases with the increase of D-D and the decrease of AT-Ⅲ at admission. Both can effectively assist other indicators in predicting the risk of MODS in patients.
