PB1046 - Early Warning Indicators for Traumatic Lung Injury-Related Coagulopathy: A Retrospective, Single Center Study

Background: Traumatic Lung Injury (TLI) is one of the major causes of traumatic death. Coagulation disorders are a common complication of TLI and a major contributing factor to the increased mortality rate. Currently, traumatic coagulopathy is mainly diagnosed based on the prolongation of PT and APTT, and the increase in INR, but the specific criteria have not been established. Therefore, this study aims to explore the early warning indicators of related coagulation disorders.

Aims: To investigate the early warning indicators and clinical value of traumatic lung injury (TLI)-related coagulopathy

Methods: 106 TLI patients admitted to the intensive care unit of the 908th Hospital from March 2018 to November 2022 were divided into survival group (n=88) and death group (n=18) based on their 28-day prognosis. Random forest model, least absolute shrinkage and selection operator (LASSO) regression and support vector machine recursive feature elimination (SVM-RFE) were used to identify the hematological factors related to TLI-related coagulopathy. The receiver operating characteristic (ROC) curve analysis was used to determine the value of INR in predicting the prognosis of TLI patients, and the patients were divided into INR ≥1.36 group (n=35) and INR < 1.36 group (n=71) according to the cut-off value of INR, and the 28-day survival rate was compared by Kaplan-Meier analysis

Results: Random forest model, LASSO and SVM-RFE determined that INR was a risk factor for TLI patients. The area under the ROC curve of INR in predicting the 28-day mortality of TLI patients was 0.826 (95% CI 0.733-0.938), and the cut-off value was 1.36. The 28-day mortality risk of TLI patients with INR ≥1.36 was 8.5 times that of those with INR < 1.36.

Conclusion(s): INR ≥1.36 can be used as an early warning indicator of TLI-related coagulopathy, and TLI-related coagulopathy patients have a significantly increased risk of death