Influence Of Platelet And Other Related Coagulation Indexes On Short-term Prognosis Of Patients With Sepsis In Xining Area

Objective To study the predictive value of platelet and other related coagulation indexes in Xining area on short-term prognosis of sepsis patients.Method A single-center,recurrent observational study was conducted to analyze the patients with sepsis who met the inclusion criteria in the EICU Hospital of Qinghai University for 2019.11-2020.12.Patients were divided into survival and survival groups based on 28 days of prognosis,and platelet intervention values of 50×10~9/L were divided into two groups according to the 2018 sepsis diagnosis and treatment guidelines.(1)ROC curve was used to analyze the relationship between the 28-day prognosis and coagulation index of sepsis patients and to judge the correlation between it and SOFA score.(2)Kaplan-Meier survival analysis was performed to evaluate the effect of PLT<50×10~9/L and PLT≥50×10~9/L on the short-term prognosis of sepsis patients.Result 1、A total of 108 septic patients were included in this study,68 died(62.96%),of whom 15 were diagnosed with sepsis(35.71%)and 53 were diagnosed with septic shock(80.30%).2、There was no significant difference in sex,PT,APTT between survival group and death group.Age(66.3 years old VS 58.30 years old,P=0.004),PLR(180.64 VS 138.36,P=0.021),PDW(19.99%VS 16.07%,P=0.000),MPV(16.74 fl VS 9.23 fl,P=0.000),MPV/PLT(0.116 VS 0.088,P=0.047),APACHE-II(17.9 VS 13.2,P=0.000),SOFA score(9.4 VS 5.9,P=0.000)were higher in the death group;Lym(0.50 VS 0.83×10~9/L,P=0.004),PLT(77.28 VS 102.00×10~9/L,P=0.004)are lower;The sensitivity of PLT,PLR,MPV,MPV/PLT was 30.88%,51.47%,98.53%,94.12%,and the specificity was 97.50%,77.50%,87.50%,42.50%,respectively.The MPV had the highest area under the curve(0.948),followed by MPV/PLT(0.681),PLT(0.667)and PLR(0.641).Correlation analysis:PLR,MPV and SOFA scores were positively correlated,and PLT and SOFA scores were negatively correlated.3、The 28-day survival rate of patients in the PLT<50×10~9/L group was significantly lower than that in the PLT≥50×10~9/L group,and the median survival time was 3 days and 25 days respectively(Log-rankχ~2=10.9272,P<0.05).The 28-day survival rate of patients in the PLT<55×10~9/L group was significantly lower than that in the PLT≥55×10~9/L group,and the median survival time was 3 days and 25 days respectively(Log-rankχ~2=11.4302,P<0.05).Conclusion 1、PLT,PLR,MPV,MPV/PLT,PDW are related to the prognosis of patients with sepsis;2、PLR,MPV,MPV/PLT and PDW can be gradually used as valuable adjuvants for clinical assessment of short-term mortality in patients with sepsis.;3、Based on the guideline recommended intervention values,the 28-day prognosis for patients with sepsis below the recommended value is significantly worse than the prognosis for patients with sepsis above the recommended value.