Clinical value analysis of sepsis-induced coagulopathy modified scoring system
Objective To investigate the clinical significance of the modified scoring system for sepsis-induced coagulopathy(SIC).Methods A retrospective analysis was performed on patients with sepsis admitted to the Department of Critical Care Medicine of the 908 t h Hospital of PLA Joint Logistic Support Force from May 2018 to April 2021.The patients were divided into two groups according to the modified SIC scoring system:sepsis group(n=222)and SIC group(n=120).The APACHE Ⅱ scores,blood test results,liver and kidney function markers,lactate levels,and coagulation profile of patients within two hours of their admission to the intensive care unit(ICU)were compared between the two groups.The predictive and prognostic value of the modified SIC scoring system for disseminated intravascular coagulation(DIC)were compared with the International Society on Thrombosis and Haemostasis(ISTH)SIC scoring system by the receiver operating characteristic(ROC)curve analysis.Results The APACHE Ⅱ scores in the sepsis-induced coagulopathy(SIC)group[(26.07±6.56)points]were significantly higher compared to the sepsis group[(21.76±6.84)points],as was the ICU mortality rate[48.3%versus 20.3%],with these differences being statistically significant(P<0.05).Patients with sepsis-induced coagulopathy(SIC)exhibited significantly prolonged activated partial thromboplastin time(APTT)and thrombin time(TT),reduced levels of fibrinogen and antithrombin,as well as significantly elevated levels of fibrin degradation products(FDP)and D-dimer,compared to the sepsis group(P<0.05).Additionally,thromboelastography(TEG)parameters such as the R and K values were significantly increased,the Angle was notably decreased,and the maximum amplitude(MA)value was significantly higher in the SIC group(P<0.05).Furthermore,plasma levels of thrombomodulin(TM),thrombin-antithrombin complex(TAT),and tissue plasminogen activator-inhibitor complex(t-PAIC)were all significantly elevated in the SIC group(P<0.05).ROC analysis showed that the area under the curve(AUC)of ISTH-SIC scores for DIC prediction was 0.91.At a SIC,score of 4 points,the sensitivity and specificity were 1.00 and 0.63,respectively.The AUC of the SIC modified scoring system for DIC prediction was 0.94.At a mSIC score of 4 points,the sensitivity and specificity were 1.00 and 0.73,respectively.The AUC of the modified SIC scoring system for DIC prediction was significantly higher than that of ISTH-SIC scoring system,and the difference was statistically significant(P=0.013).Conclusion The modified SIC scoring system enhances the specificity of diagnosing SIC and predicting the onset of DIC.
NETL
NSTL
万方数据
维普
