Abstract: Objective To explore the relationship between the changes in thromboelastography(TEG) parameters and the levels of thrombomodulin(TM) in patients with traumatic brain injury(TBI). Methods A total of 179 patients with TBI who were admitted from January 2020 to June 2024 were selected. The correlation between TM and TEG parameters was analyzed using the Local Weighted Regression Scatter Smoothing Method(LOWESS). Multivariate Logistic regression was used to analyze the factors associated with poor prognosis in TBI patients; Generalized Linear Model and Restricted Cubic Spline were used to analyze the relationship between TM and poor prognosis in patients with different severity of TBI. Results TM was positively correlated with the α angle and Ma, and negatively correlated with the K value and R value(P＜0.05). The increase in the α angle, Ma, TM, K value, and R value was an influencing factor for the poor prognosis of TBI patients(P＜0.05). The TM level showed a non-linear dose-response relationship in the prognosis of poor outcomes in patients with mild, moderate, and severe TBI(P_{non-linearity}＜0.05). When the K value was less than 1.05 min, the correlation between the TM level and the risk of poor prognosis in TBI patients was more significant(P_interaction＜0.01). Conclusions The increases in α angle, Ma, TM, K value, and R value are factors influencing the poor prognosis of TBI patients.

Key words: brain injury, traumatic brain injury, thromboelastography, thrombomodulin