Association of composite liver function indices with trauma-induced coagulopathy in adult trauma patients
- 1ongyang Hospital of Wenzhou Medical University, Dongyang/Jinhua, Zhejiang, China
Abstract
ObjectiveTrauma-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.MethodologyThis 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.ResultsALBI 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.ConclusionALBI 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.
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BibTeX
@article{hu2026association,
title = {{Association of composite liver function indices with trauma-induced coagulopathy in adult trauma patients}},
author = {Jiejun Hu and Xinxin Chen and Jiao Bao and Weichao Lu and Manzhen Ying},
journal = {Frontiers in Surgery},
year = {2026},
month = oct,
doi = {10.3389/fsurg.2026.1860161},
url = {https://doi.org/10.3389/fsurg.2026.1860161},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association of composite liver function indices with trauma-induced coagulopathy in adult trauma patients
AU - Jiejun Hu
AU - Xinxin Chen
AU - Jiao Bao
AU - Weichao Lu
AU - Manzhen Ying
PY - 2026
DA - 2026/10/23
JO - Frontiers in Surgery
DO - 10.3389/fsurg.2026.1860161
UR - https://doi.org/10.3389/fsurg.2026.1860161
AB - ObjectiveTrauma-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.MethodologyThis 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.ResultsALBI 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.ConclusionALBI 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.
SN - 2296-875X
ER -