THE PREDICTIVE VALUE OF INDEPENDENT RISK FACTORS OF MODS AND MODS EARLY WARNING SCORE ON MODS OCCURRENCE IN SEVERE TRAUMA PATIENTS

Xiaogong Gong¹, Wei Yuan¹, Helong Li¹, Bo Meng¹, Yaling Nie², Bin Peng^{2, *}

¹Department of Emergency Surgical Ward, Hainan Provincial People's Hospital, Haikou, PR China - ²Department of ICU, Yunyang County People’s Hospital, Chongqing, PR China

Objective: To analyse the predictive value of the independent risk factors of multiple organ dysfunction syndrome (MODS), and MODS early warning score on the occurrence of MODS in severe trauma patients. 

Methods: 180 trauma patients admitted to our hospital's intensive care unit (ICU) from August 2016 to August 2018 were selected, and the general data, vital signs, laboratory indicators, related scores, cause and location of injury, and the occurrence of shock, blood transfusion, intubation, and infection after admission of all patients were collected. Single factor analysis was used to analyse MODS-related factors of in severe trauma patients, and logistic regression was used to analyse the independent risk factors that affected MODS; the ROC curve was used to analyse the predictive value of MODS warning scores. 

Results: The heart rate, the levels of blood Na⁺, sCr, aPTT, and the ISS, SOFA, NISS, and APACHEⅡ scores of patients in the MODS group were higher than those in the non-MODS group (P<0.05); the scores for RBC, ALB, PLT, blood PH, and GCS were lower than those of non-MODS group (P<0.05). The number of patients with multiple injuries, shock, transfusion, intubation, and infections after admission in the MODS group was higher than in the non-MODS group (P<0.05). There was no significant difference in other indicators between the two groups (P>0.05). An APACHEⅡ ≥ 15 points, a SOFA score of 4-6 points, a SOFA score ≥7 points, an aPTT >40s, injury sites ≥3, and hospital shock were independent risk factors that affected MODS in patients with severe trauma (P<0.05). The sensitivity score of the MODS warning score was 66.24%, the specificity was 85.05%, and the area under the curve (AUC) was 0.823, which was superior to those of the APACHEⅡ and SOFA scores. 

Conclusion: An APACHEⅡ ≥15 points, a SOFA ≥4 points, an aPTT >40s, injury sites ≥3, and hospital shock are independent risk factors for MODS in patients with severe trauma. The MODS warning score composed of the above indicators in predicting the occurrence of MODS is better than the APACHEⅡ and SOFA scores, which can be used as a scoring system for the clinical prediction of MODS.