Risk factors of early disseminated intravascular coagulation in pediatric patients with septic shock
Wang Ruolan
Du Xingyue
Guo Xin
Xiang Dandan
Liu Jingtao
Zhou Yalan
Qi Xusheng
Abstract：Objective To analyze the risk factors for early disseminated intravascular coagulation(DIC)in pediatric patients with septic shock,in order to provide clinical references for the prevention of DIC in such patients.Methods A total of 198 pediatric patients with septic shock,admitted to Taihe Hospital from January 2020 to December 2024,were selected as the study participants.Pediatric patients were allocated to two groups based on the presence or absence of early DIC:the DIC group(n=75)and the non-DIC group(n=123).Clinical data of the two groups were collected,and a logistic regression model was constructed to analyze the risk factors for early DIC in these children.Results There were no statistically signifi-cant differences between the two groups in gender,age,infection site,blood pressure,body temperature,respiratory rate(RR),heart rate(HR),blood urea nitrogen(BUN),serum creatinine(SCr),total bilirubin(TBil),aspartate aminotrans-ferase(AST),alanine aminotransferase(ALT),oxygenation index,albumin(ALB),white blood cell count(WBC),lym-phocyte count(LY),neutrophil count(NEUT),or C-reactive protein(CRP)levels(P＞0.05).In the DIC group,the proportions of pediatric patients with low platelet count(PLT)(＜100 × 109/L),low fibrinogen(FIB)levels(＜2 g/L),high procalcitonin(PCT)levels(≥0.5 μg/L),high D-dimer(D-D)levels(≥0.2 mg/L),and high lactate levels(＞1.8 mmol/L)were higher than those in the non-DIC group,with statistically significant differences(P＜0.05).Logistic re-gression analysis showed that PLT levels(OR=0.303,95％CI:0.166-0.555),FIB levels(OR=0.352,95％CI:0.206-0.601),PCT levels(OR=28.276,95％CI:12.536-63.777),D-D levels(OR=13.105,95％CI:6.090-28.201),and lactate levels(OR=36.089,95％CI:13.439-96.916)were influence factors for early DIC in this population(P＜0.05).Conclusion In pediatric patients with septic shock and early DIC,the levels of PLT and FIB are decreased,while PCT,D-D,and lactate levels are elevated.Low PLT levels,low FIB levels,high PCT levels,high D-D levels,and high lactate levels are influence factors for DIC.Clinically,dynamic monitoring of PLT,FIB,PCT,D-D,and lactate levels can help to early identify high-risk pediatric patients for DIC,enabling timely interventions to promote the prognosis of these patients.
Keywords：SepsisSeptic shockChildrenComplicationsDisseminated intravascular coagulationRisk factors
Publication Date：2025-06-20
Online Publishing Date：2025-10-13(First online date of this platform, not the publication date of the document)
Pages：6( 78-83 )