Objective To explore the impact of abnormal coagulation function on prognosis in patients with fever complicated with thrombocytopenia syndrome (SFTS), and evaluate its relationship with bleeding events.
Methods The clinical data and laboratory test indicators of 43 patients with SFTS were retrospectively analyzed. The baseline characteristics and laboratory indicators differences between the survival group and death group were compared. Multivariate logistic regression analysis was used to screen for prognostic risk factors, and the ROC curve was plotted to evaluate the predictive value of related indicators.
Results The proportions of consciousness disorders and bleeding events, levels of tyrosine transferase, γ -glutamyl transferase, creatinine (Cr), creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase and C-reactive protein, prothrombin time, thrombin time (TT), activated partial thromboplastin time, international normalized ratio and D-dimer levels in the death group were higher than those in survival group (P ＜ 0.05 to P ＜ 0.01), while the average platelet count, and levels of blood calcium and fibrinogen water were lower than those in survival group (P ＜ 0.05). The results of logistic regression analysis showed that the levels of TT and Cr increasing were the independent risk factors of death in SFTS (P ＜ 0.05). The results of ROC analysis showed that the AUC of TT alone in predicting the mortality outcome of patients with SFTS was 0.771, while the AUC of TT combined with Cr was 0.846. Among the coagulation indicators, D-dimer has the best efficacy in predicting bleeding events in patients with SFTS, with an AUC of 0.796.
Conclusions Abnormal coagulation function in patients with SFTS is closely related to the prognosis and occurrence of bleeding events. TT and Cr can be used as clinical indicators for evaluating prognosis. Among abnormal coagulation indicators, especially the D-dimer increasing is more helpful in predicting bleeding events than platelet count decreasing.
DownLoad: