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D⁃dimer and lactic acid combined with sPECAM⁃1 in the prediction of poor prognosis in patients with sepsis⁃related disseminated intravascular coagulation
Received date: 2023-05-28
Online published: 2023-10-10
Objective To investigate the predictive value of D?dimer （D?D）， lactic acid， and soluble platelet endothelial adhesion molecule?1 （sPECAM?1） in patients with sepsis?associated disseminated intravascular coagulation （DIC）. Methods According to the prognosis of patients at 28 days， 300 patients with sepsis?related DIC in the ICU of the Affiliated Hospital of Xuzhou Medical University were gathered and split into death and survival groups. The two groups' general statistics， APACHEⅡ score， serum D?D， lactate， and sPECAM?1 levels were compared. The operating characteristic curve （ROC） was used to evaluate the predictive value of serum D?D， lactate， and sPECAM?1 on the poor prognosis of patients with sepsis?related DIC. Results The 28?day mortality rate of patients with sepsis?related DIC was 22%， and the death group had higher APACHEⅡ scores， serum D?D， lactate， and sPECAM?1 levels than the survival group （P < 0.05）. Multivariate logistic regression results showed that serum D?D， lactic acid and sPECAM?1 were risk factors for 28?day death in patients with sepsis?related DIC.The AUC of serum D?D， lactic acid， and sPECAM?1 was 0.863 （95%CI： 0.768 ~ 0.958）， 0.831 （95%CI： 0.734 ~ 0.928）， 0.774 （95%CI： 0.653 ~ 0.896）， respectively. The AUC of the combination of serum D?D， lactic acid and sPECAM?1 was 0.965 （95%CI： 0.928 ~ 1.000）， with the sensitivity 0.864 and the specificity 0.974， each of which were greater than the individual predictions. Conclusion In patients with sepsis?related DIC， higher serum D?D， lactate， and sPECAM?1 levels were highly correlated with 28?day death.In patients with sepsis?related DIC， higher serum D?D， lactate， and sPECAM?1 levels were highly correlated with 28?day death. The combination of serum D?D， lactate， and sPECAM?1 levels provided a high predictive value for the prognosis of sepsis?related DIC and might be employed in therapeutic treatment.
Ziwen WANG , Wenjing ZHAO , Yali. CHAO . D⁃dimer and lactic acid combined with sPECAM⁃1 in the prediction of poor prognosis in patients with sepsis⁃related disseminated intravascular coagulation[J]. The Journal of Practical Medicine, 2023 , 39(18) : 2379 -2383 . DOI: 10.3969/j.issn.1006-5725.2023.18.016
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