Objective:To explore the risk factors of acute traumatic coagulopathy(ATC)in patients with severe trauma,and construct its nomogram prediction model.Methods:178 patients with severe trauma were selected as the research subjects.They were divided into ATC group(n=60)and non-ATC group(n=118)according to whether ATC occurred.The clinical data of patients were collected,and the independent risk factors of ATC in patients with severe trauma were established by univariate and Logistic multivariate regression analysis.R software was used to construct a nomogram prediction model for ATC in patients with severe trauma by incorpora-ting the screened independent risk factors,and the receiver operating characteristic(ROC)curve was drawn to verify the predictive effi-cacy of the model.Results:Of the 178 patients with severe trauma,60 had ATC,with an incidence of 33.71％(60/178).Univariate analysis showed that the blood transfusion and blood product use in ATC group were higher than those in non-ATC group(P＜0.05).APTT,TT,INR,BUN,lactic acid,BE,and SI in ATC group were higher than those in non-ATC group(P＜0.05),FIB and PLT were lower than those in non-ATC group(P＜0.05).Multivariate Logistic regression analysis showed that low FIB(OR=0.557),low PLT(OR=0.692),high lactic acid(OR=1.241),and high SI(OR=1.533)were independent risk factors for ATC in patients with se-vere trauma(P＜0.05).The ROC curve showed that the area under the curve(AUC)of the nomogram prediction model was 0.895(95％CI=0.840～0.936),and the sensitivity and specificity were 85.00％and 83.90％,respectively.Conclusion:Low FIB,low PLT,high lactic acid,and high SI are independent risk factors for ATC in patients with severe trauma.The nomogram prediction model constructed on this basis can better predict the probability of ATC in patients.