凝血功能与脓毒症并癌症患者72小时死亡率的相关分析  

The Correlation Analysis Between Coagulation Function and 72-hour Mortality Among Septic Patients with Cancer

作　　者：秦伟强 余涛[1] 李莉[1] QIN Wei-qiang;YU Tao;LI Li(Department of Emergency Medicine,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,510120)

机构地区：[1]中山大学孙逸仙纪念医院急诊科,510120

出　　处：《岭南急诊医学杂志》2023年第3期207-210,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨凝血功能与脓毒症并癌症患者72小时死亡率的相关关系。方法:从Dryad数据库中提取176名脓毒症并癌症患者的临床及实验室数据。采用单因素分析患者72小时死亡率的危险因素,以及凝血功能包括凝血酶原时间(Prothrombin Time,PT)、活化部分凝血活酶时间(Activated Partial Thromboplastin Time,APTT)和国际标准化比值(International Normalized Ratio,INR)与患者72小时死亡率的相关性。并使用广义相加模型(Generalized Additive Model,GAM)来确定INR的最佳截点值。结果:单因素分析显示,调整混杂因素后,PT、APTT和INR与72小时死亡率显著相关(P<0.01)。INR的最佳诊断截点值为2.80。结论:在脓毒症并癌症患者中,入院时PT、APTT和INR是72小时死亡的独立预测因子。INR对72小时死亡率具有更高的预测价值。Objective:Exploring the correlation between coagulation function and 72-hour mortality in septic patients with cancer.Methods:Extracting clinical and laboratory data of 176 septic patients with cancer from the Dryad database,we performed univariate analysis to identify the risk factors associated with 72-hour mortality in these patients.Coagulation function,including Prothrombin Time(PT),Activated Partial Thromboplastin Time(APTT),and International Normalized Ratio(INR),was also analyzed for its correlation with 72-hour mortality.Additionally,a Generalized Additive Model(GAM)was used to determine the optimal inflection point for INR.Results:Univariate analysis showed that PT,APTT,and INR were significantly associated with 72-hour mortality after adjusting for confounding factors.INR showed a nonlinear correlation with 72-hour mortality,with an estimated inflection point of 2.80.Conclusion:After adjusting for confounding factors,univariate analysis showed that PT,APTT,and INR were significantly associated with72-hour mortality rate(P<0.01).The optimal diagnostic cut-off value for INR was 2.80.

关 键 词：脓毒症 凝血功能 72小时死亡率 预测价值 

分 类 号：R459.7[医药卫生—急诊医学] R730.5[医药卫生—治疗学]