Abstract：
This study aimed to identify the long-term D-dimer trajectory patterns and their associations with in-hospital all-cause mortality in abdominal trauma patients. This is a retrospective cohort study of general adult abdominal trauma patients admitted to Jinling Hospital (Nanjing, China) between January 2010 and April 2020. Group-based trajectory modeling was applied to model D-dimer trajectories over the first 50 days post-trauma. A multivariable logistic regression was performed to estimate the associations between D-dimer trajectories and in-hospital all-cause mortality. A total of 309 patients were included. We identified four distinct D-dimer trajectories: group 1 (57.61%; \"stable low\"), group 2 (28.16%; \"moderate-decline\"), group 3 (8.41%; \"high-rapid decline\"), and group 4 (5.83%; \"high-gradual decline\"). The SOFA score (p = 0.005) and ISS (p = 0.001) were statistically higher in groups 3 and 4 than in groups 1 and 2. The LMWH and UFH did not differ between groups 3 and 4. Compared with the patients in group 1, only the patients in group 4 were at a higher risk of in-hospital all-cause mortality (OR = 6.94, 95% CI: 1.20-40.25). The long-term D-dimer trajectories post-trauma were heterogeneous and associated with mortality. An initially high and slowly-resolved D-dimer might function as the marker of disease deterioration, and specific interventions are needed.
摘要：
本研究旨在确定腹部创伤患者的长期D-二聚体轨迹模式及其与院内全因死亡率的关系。这是金陵医院收治的一般成人腹部创伤患者的回顾性队列研究（南京，中国）2010年1月至2020年4月。基于组的轨迹建模应用于创伤后前50天的D-二聚体轨迹建模。进行了多变量逻辑回归以估计D-二聚体轨迹与院内全因死亡率之间的关联。共纳入309名患者。我们确定了四个不同的D-二聚体轨迹：第1组（57.61%；“稳定低”），第2组（28.16%；“中度下降”），第3组（8.41%；“快速下降”），和第4组（5.83%；“高度渐进下降”）。第3组和第4组的SOFA评分（p=0.005）和ISS评分（p=0.001）在统计学上高于第1组和第2组。LMWH和UFH在第3组和第4组之间没有差异。与第1组患者相比，只有第4组患者的院内全因死亡率风险更高（OR=6.94，95％CI：1.20-40.25）。创伤后的长期D-二聚体轨迹是异质的，并且与死亡率相关。最初高且缓慢分辨的D-二聚体可能作为疾病恶化的标志物，需要具体的干预措施。
