Work

Association of composite liver function indices with trauma-induced coagulopathy in adult trauma patients

Year: 2026

Type: article

Abstract: Objective: Trauma-induced coagulopathy (TIC) is a life-threatening complication associated with uncontrolled hemorrhage and high mortality in critically ill trauma patients. This study aimed to evaluate the associations and discriminative performance of four composite liver-function indices-ALBI, TBil/ALB, DBil/TBil, and GGT/ALP-with TIC-related outcomes in adult trauma patients. Methodology: This single-center retrospective cohort study included 634 adult trauma patients. Laboratory data were collected at baseline, 24 h after admission, and 48 h after admission. The primary outcome was the continuous ISTH DIC score assessed 48 h after admission. Overt DIC, non-overt DIC, and ATC were analyzed as secondary or exploratory TIC-related outcomes. Multivariable models adjusted for age, sex, admission lactate, admission pH, admission temperature, traumatic brain injury, hepatic injury, and surgery. Associations between each index and TIC-related outcomes were examined using multivariable linear and logistic regression analyses. Results: ALBI showed the most consistent associations with TIC-related outcomes and the strongest index-alone discrimination for non-overt DIC among the evaluated indices. The TBil/ALB ratio retained independent predictive value, though with somewhat lower overall consistency. The DBil/TBil and GGT/ALP ratios, by contrast, exhibited weaker associations that varied across time points and outcome definitions. Serial measurements over the first 24 h contributed incremental prognostic information; however, no dynamic index outperformed the baseline ALBI score in predictive strength. Conclusion: ALBI was consistently associated with TIC-related outcomes assessed 48 h after admission, and this association remained stable across the examined clinical subgroups. ALBI may serve as a readily available adjunctive risk marker for early coagulopathy risk stratification. Prospective validation is warranted before clinical implementation.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2026.1860161

Authors: Jiejun Hu, Xinxin Chen, Jiao Bao, Weichao Lu, Manzhen Ying

Institution: Wenzhou Medical University

Language: English

Topic: Trauma, Hemostasis, Coagulopathy, Resuscitation

Subfield: Critical Care and Intensive Care Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801