| Objectives:To explore the effect of coagulation dysfunction on the prognosis of Staphylococcus aureus(S.aureus)sepsis in children.Methods:The clinical data of S.aureus sepsis in 130 children from January 2014 to February 2018 were analyzed retrospectively.According to the outcome,the patients were divided into survival group and non-survival group.Univariate and multivariate logistic regression analysis were carried out,and ROC analysis was performed for related indicators of coagulation function.Results:In the 130 patients(68 boys;62 girls)with a median age of54.0 months(10.7~129.8 months),34 died and mortality was 26.2%.The detection rate of methicillin-resistant S.aureus,procalcitonin,C-reactive protein,platelet distribution width,activated partial thromboplastin time,thrombin time,D-dimer level,the proportion of prothrombin time≥17s in the death group were significantly higher than those in the survival group,and the platelet count and fibrinogen were significantly lower than those in the survival group(all P<0.05).Multivariate logistic regression analysis showed that primary blood flow infection,methicillin-resistant S.aureus infection,prothrombin time(PT)extension,increased D-dimer and thrombocytopenia were independent risk factors for death(all P<0.05).When PT was 17s,D-dimer was 5.9 mg/L and platelet was 50×10~9/L,area under the ROC curve(AUC)was 0.853,0.870 and 0.889,respectively.The sensitivity of predicting death was 88.24%,88.24%and 52.94%,and the specificity was 83.33%,83.33%and 97.92%,respectively.When combined the above three indicators of coagulation function,the ROC analysis showed that the sensitivity and specificity of predicting death were 85.29%and 94.79%,respectively,and the AUC was 0.936.Conclusion:When prothrombin time≥17s,D-dimer≥5.9 mg/L,platelets≤50×10~9/L,the risk of death in children with S.aureus sepsis increased,and the value of combination of three indicators to predict the death of children was higher. |
