Changes of coagulation function and its correlation with prognosis in patients with sepsis after anticoagulant treatment / 国际检验医学杂志

ABSTRACT

Objective To investigate the changes of coagulation function in patients with sepsis after anti-coagulant treatment and its correlation with prognosis.Methods The clinical data of 132 patients with sepsis in our hospital were analyzed retrospectively,and all the patients were given routine anti-infection,fluid re-placement,acid suppression,organ support and anticoagulant treatment.The prognosis was recorded within 1 month after admission,the patients enrolled in the study were divided into the death group(46 cases)and the survival group(86 cases).T he sex,age and coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),two D-dimer(D-D),platelet count (PLT)]of the patients were compared between the two groups.Logistic multiple factor regression analysis was performed.At the same time,ROC curves for predicting the risk of death in patients by using coagulation function were drew.Results After the anticoagulant treatment,PT,APTT,TT,FIB,D-D values of the sur-vival group were lower than the death group,and PLT was higher than the death group(P < 0.05).Logistic multivariate regression analysis showed that PT,APTT and PLT were independent factors in the mortality of sepsis patients(P<0.05).The area under the curve(AUC)of PT for predicting death risk was 0.815,when the best cut-off value was 13.84 s,the sensitivity was 0.870 and specificity was 0.698.The AUC of APTT for predicting death risk was 0.756.,when the best cut-off value was 38.95 s,the sensitivity was 0.848 and speci-ficity was 0.698.The AUC of PLT for predicting death risk was 0.826,when the best cutoff value was 216.62×109,the sensitivity was 0.686 and the specificity was 0.913.Conclusion After anticoagulant treat-ment ,PT ,APTT and PLT are independent prognostic factors of sepsis ,and they have some predictive valuefor the risk of death .