Risk Factors for Mortality in Critically Ill Patients with Coagulation Abnormalities:A Retrospective Cohort Study  

作　　者：Qiu-yu GUO Jun PENG Ti-chao SHAN Miao XU 

机构地区：[1]Department of Hematology,Qilu Hospital of Shandong University,Jinan,250012,China [2]Department of Critical Care Medicine,Qilu Hospital of Shandong University,Jinan,250012,China

出　　处：《Current Medical Science》2024年第5期912-922,共11页当代医学科学（英文）

基　　金：supported by grants from National Key R&D Program of China(No.2023YFC2507800);ECCM Program of Clinical Research Centre of Shandong University(No.2021SDUCRCB008);Young Taishan Scholar Foundation of Shandong Province(No.tsqn201812133);the Fundamental Research Funds of Shandong University(No.2020QNQT001);National Natural Science Foundation of China(No.81900124).

摘　　要：Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.

关 键 词：blood coagulation markers MORTALITY risk factors disseminated intravascular coagulation intensive care unit 

分 类 号：R459.7[医药卫生—急诊医学]