Analysis Of The Correlation Between Coagulation Function And Prognosis In ARDS Induced By Extrapulmonary Sepsis And Pulmonary Infection

Objective: Acute respiratory distress syndrome is the most common critical care syndrome in Intensive Care Unit(ICU).Studies have found inflammation and coagulation activation play an important role in the development of ARDS,but few have conducted profoundly about the coagulation function of ARDS patients with different etiology.The purpose of this study was to explore the difference of coagulation function in ARDS patients induced by extrapulmonary sepsis and pulmonary infection,and correlation between it and prognosis.Find the coagulation indicators with predictive value which are related to the cause,and take early intervention.Methods: In July 2017 to June 2019,240 ARDS patients with extrapulmonary sepsis and pulmonary infection were enrolled in a retrospective study in the ICU of the First Affiliated Hospital of China Medical University,including 145 extrapulmonary sepsis patients and 95 pulmonary infection patients.Collected the basic characteristics,coagulation parameters and prognostic information.Using Statistical Product and Service Solutions(SPSS)25.0 for statistical analysis.Continuous variables applied to the Mann-Whitney U test for comparison,and all continuous variables are represented by medians with interquartile ranges(IQRs).Variables with significant differences in the univariate analysis were gradually incorporated in the multiple-factor regression analysis,determining the coagulation indicators affected the prognosis of for ARDS.Results: PT(16.9s vs.15.8s),INR(1.38 vs.1.28),APTT(48.9s vs.43.5s)in the extrapulmonary sepsis group were significantly higher than pulmonary infection ARDS group(P<0.05).AT-III(56 vs 75)level was lower in pulmonary infection ARDS group(P<0.05).Compared with survival patiens,patients with 28 days death group had higher PT(18.45 s vs.16.5s),INR(1.54 vs.1.34),APTT(50.7s vs.46s),but AT-III(48 vs.60)was lower,which differences were statistically significant(P<0.05).The mortality rate was 48.4%(49/95)in pulmonary infection ARDS group,and the coagulation parameters were no significant difference between those groups.Multivariate regression analysis results showed SOFA score without PLT(OR=1.21,95% CI was 1.067～1.372,P=0.003),INR(OR=2.408,95% CI was 1.007～5.760,P=0.048)were independent risk factors of 28-day death in extrapulmonary sepsis group.Conclusion: There were statistically significant differences in coagulation parameters between extrapulmonary sepsis ARDS patients and pulmonary infection patients.INR was independent risk factors of 28-day death in extrapulmonary sepsis group.