In 223 adults with severe trauma, higher admission AISI was independently associated with ultrasound-confirmed in-hospital lower-extremity DVT and improved discrimination over clinical variables, but its added value beyond coagulation markers was uncertain and requires prospective external validation; AISI should be interpreted as a complementary admission marker.
Lower-extremity DVT was common in this severe trauma cohort, affecting 41.7% of patients with evaluable ultrasonography.
Higher admission AISI was independently associated with LEDVT after adjustment for clinical covariates.
The association between AISI and LEDVT persisted after additional adjustment for coagulation markers, though the effect size was somewhat attenuated.
Adding AISI to clinical variables significantly improved discrimination for LEDVT.
When coagulation markers were already in the model, AISI's added discrimination was small and statistically uncertain, though overall prediction accuracy (Brier score) improved.
Internal validation of the full model (Model 4) showed good discrimination but evidence of optimism/shrinkage.
The authors conclude AISI is a complementary admission marker requiring prospective external validation.
This study looked at whether a blood-count-based inflammation score measured when severely injured patients arrive at the hospital could help identify who will develop blood clots in the leg veins (deep vein thrombosis, DVT). The score, called AISI, is calculated from routine counts of platelets and several white blood cell types. Among 223 severely injured adults who had leg ultrasound scans, about 42% developed DVT. Patients with higher AISI at admission were substantially more likely to have DVT, even after accounting for age, sex, injury severity, level of consciousness, shock, and standard clotting tests. Adding AISI to basic clinical information noticeably improved the ability to tell who would and would not develop DVT. However, once standard clotting blood tests were also considered, the extra benefit in distinguishing patients was small and uncertain, though overall prediction accuracy improved slightly. This research suggests AISI, which uses inexpensive routine blood tests, may be a useful complementary signal of DVT risk after major trauma. The study was retrospective and relatively small, and the prediction model's performance was somewhat overoptimistic in internal testing, so the findings need confirmation in prospective studies at other hospitals before being used in practice.
Sun Q, Bian D. (2026). Association of admission aggregate index of systemic inflammation with lower-extremity deep vein thrombosis after severe trauma.. PloS one. https://doi.org/10.1371/journal.pone.0360039