To investigate the association of parameters of thrombelastography (TEG) with disease progression and outcome in patients with multiple organ dysfunction syndrome (MODS) complicated by severe brain trauma and to analyze their clinical significance.

A total of 126 cases with severe brain trauma complicated with MODS admitted to the Department of Intensive Care Medicine of our hospital from March 2020 to July 2021 were included. The Sequential Organ Failure Assessment (SOFA) score of each patient on admission was set as the baseline. One hundred and twenty-six patients were divided into either a disease progression group (n=38) or a stable disease group (n=88) according to whether SOFA score was increased by ≥2 points from the baseline within 1 week. Then, the differences of TEG parameters between the two groups were compared and their predictive value for the progression of MODS complicated by severe brain trauma was further evaluated.

Univariate analysis revealed that the R value and α angle showed a significant difference between the two groups, while gender showed no difference. Multivariate logistic regression analysis revealed that the decrease of R value was independently associated with the progression of MODS (odds ratio=0.371, 95% confidence interval: 0.243~0.568). The progression hazard of MODS increased 0.629 times when R value decreased by 1 min. The predictive performance of R value for MODS was analyzed using the receiver operating characteristic curve, and the area under the curve of R value was 0.121 when the cut-off value was 1.900, indicating that R value is a potent marker to predict the occurrence of MODS.

The decrease of R value measured by TEG can be used to predict the progression of MODS complicated by severe brain trauma, and it has the potential to guide clinical intervention in a more convenient way.