Relationship between coagulation dysfunctions and prognosis in senile patients with sepsis

TIAN Hong; WANG Hong-xia

doi:10.3969/j.issn.1002-1949.2014.11.03

Abstract：Objective To investigate the relationship between the changes of coagulation function and the prognosis in the senile patients with sepsis.Methods In this retrospective study, 62 senile patients with sepsis between May 2011 and July 2013 were collected, and 30 volunteers as the controls were involved.The patients were divided into the survival group ( n=39 ) and non-survival group(n=23) according to 28-day prognosis.Planet (PLT) count, D-dimmer (DD), prothrombin time ( PT) , thrombin time ( TT) , activated partial thromboplastin time ( APTT) and fibrinogen ( FBG) , protein C ( PC) activity were determined and APACHEⅡscore was assessed on the admission day.The differences of coagulation markers between the two groups were analyzed and the relationship between the coagulation markers and APACHEⅡscore were studied.Results The level of PC and PLT was lower (P<0.05 or P<0.01), DD was higher (P <0.01) in the non -survival group than that in the survival group.There were no differences in PT, APTT, TT and FBG between the two groups ( all P>0.05).The difference in APACHEⅡscore was significant (P<0.01) between them.The changes in PC, PLT (r=-0.690, P=0.002;r=-0.461, P=0.012) and DD (r=0.477, P=0.008) were closely correlated with the APACHEⅡ score.The results from Logistic regression analysis showed that the factors significantly related with death in the senile patients with sepsis included:PC (OR=1.104, P=0.006) and APACHEⅡ score≥20 ( OR =15.556, P =0.003).Conclusion There are dysfunctions of coagulation in the senile patients with sepsis.The PC activity is significantly correlated with APACHEⅡscore and can be predicted the outcome in the senile patients with sepsis.