Predictive value of serum complement C3a receptor 1 combined with relevant scores for prognosis of children with septic coagulopathy

Qi Gongjian; Zhang Rui; Hu Dan; Zhu Feng; Xi Xiaoying

doi:10.3760/j.issn.1673-4777.2026.02.016

Abstract：Objective To explore the predictive value of serum complement C3a receptor 1(C3AR1)combined with the international society on thrombosis and haemostasis-septic coagulopathy(ISTH-SIC)score for the prognosis of children with septic coagulopathy(SIC).Methods A total of 150 SIC children(SIC group)and 75 children with simple sepsis(simple sepsis group)admitted to Xuzhou Children's Hospital,Jiangsu Province from January 2021 to February 2025 were prospectively selected at a ratio of 2:1.Serum C3AR1 levels were detected and ISTH-SIC scores were calculated.Spearman correlation analysis was used to evaluate the correlation between serum C3AR1 levels and ISTH-SIC scores in SIC children.According to the 28 d prognosis,SIC children were divided into death group and survival group.Multivariate Logistic regression analysis was used to identify the influencing factors of prognosis in SIC children.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum C3AR1 combined with ISTH-SIC score for the prognosis of SIC children.Results Serum C3AR1 level and ISTH-SIC score in the SIC group were significantly higher than those in the simple sepsis group[6.31(4.02,9.13)μg/L vs 2.38(1.53,3.43)μg/L,5.00(4.00,6.00)vs 2.00(1.00,3.00),respectively](both P<0.001).Serum C3AR1 level was positively correlated with ISTH-SIC score in SIC children(rs=0.728,P<0.001).Among the 150 SIC children,52 died within 28 d after admission(death group,52 cases)and 98 survived(survival group),with a mortality rate of 34.7％(52/150).Multivariate Logistic regression analysis showed that international normalized ratio,pediatric sequential organ failure assessment score,C3 AR1,and ISTH-SIC score were independent risk factors for death in SIC children(all P<0.05).ROC curve analysis revealed that the area under the curve of serum C3 AR1 alone,ISTH-SIC score alone,and their combination for predicting the prognosis of SIC children was 0.828,0.737 and 0.903,respectively.The combined predictive value was superior to that of serum C3AR1 alone or ISTH-SIC score alone(all P<0.05).Conclusion Elevated serum C3AR1 level and ISTH-SIC score are associated with poor prognosis in children with SIC,and the combination of serum C3AR1 and ISTH-SIC score has high predictive value for poor prognosis.