Risk Factors for Poor Short-Term Prognosis in Children with Sepsis Combined with Coagulopathy
Objective To analyze short-term risk factors for poor prognosis in children with sepsis combined with coagulation disorders.Methods The clinical data of 226 children with sepsis combined with coagulation dysfunction admitted to the First Affiliated Hospital of Zhengzhou University were retrospectively selected as the study subjects from September 2021 to August 2023,and the children were divided into a poor prognosis group(34 cases)and a good prognosis group(192 cases)according to their 28 days prognosis.General information and indicators were compared between the two groups,risk factors for poor prognosis were screened,and the predictive value of each risk factor for poor prognosis was evaluated.Results Serum fibrinogen(Fib)and antithrombin Ⅲ(AT-Ⅲ)levels were lower in the poor prognosis group than those in the good prognosis group,and acute physiology and chronic health evaluation(APACHE Ⅱ)scores were higher than those in the good prognosis group(P＜0.05).Fib,AT-Ⅲ were protective factors for poor short-term prognosis of sepsis-combined coagulation dysfunction,and APACHE Ⅱ was an dysfunction independent risk factor for poor short-term prognosis(P＜0.05).The area under the curve(AUC)values of Fib,APACHE Ⅱ,and AT-Ⅲ combined to predict poor short-term prognosis in children with sepsis combined with coagulation dysfunction were higher than those predicted by Fib,APACHEII,and AT-Ⅲ alone(P＜0.05).Kaplan-Meier curves showed that the survival time of children with Fib＞1.67 g·L-1,APACHE Ⅱ ≤13.00 points,and AT-Ⅲ＞38.56％were longer than that of children with Fib ≤ 1.67 g·L-1,APACHE Ⅱ＞13.00 points,and AT-Ⅲ ≤38.56％(P＜0.05).Conclusion Fib and AT-Ⅲ are protective factors for short-term poor prognosis of sepsis-combined coagulation dysfunction,and APACHE Ⅱ is a risk factor for short-term poor prognosis of sepsis-combined coagulation dysfunction,and the combination of all the indexes to predict the short-term poor prognosis of sepsis-combined coagulation dysfunction is of good value,and it can be applied to promote the clinical application.
万方数据
维普
