The role of early changes in routine coagulation tests in predicting the occurrence and prognosis of sepsis

This study aimed to explore the importance of routine coagulation tests for the early detection of sepsis and to quickly identify patients at a high risk of mortality.

This retrospective single-center study collected data from patients meeting the clinical criteria for systemic inflammatory response syndrome (SIRS) with a confirmed infection source. Patients with coagulation disorders or on medications affecting coagulation were excluded. Patients were divided into sepsis and non-sepsis groups based on a Sequential Organ Failure Assessment (SOFA) score of ≥2. Univariate and multivariate logistic regression identified indicators from routine coagulation tests that predict sepsis. Prognostic roles of coagulation indicators were analyzed within the sepsis group.

A total of 512 patients were included, with 396 in the sepsis group and 116 in the non-sepsis group. The predictive factors in the sepsis prediction model encompass fibrin degradation products (FDP), D-dimer, lactate, procalcitonin (PCT) levels and the utilization of mechanical ventilation. Early elevation of FDP and D-dimer levels predicted sepsis onset. The model exhibited an area under the curve (AUC) of 0.943 (95% CI: 0.923-0.963). In the sepsis group, Cox regression analysis revealed an association between prothrombin time (PT) and in-hospital mortality.

Abnormal high FDP and D-dimer levels in the early stages of sepsis provide a supplementary method for predicting sepsis. As the disease progresses, prolonged PT in the early stages of sepsis suggests a poor prognosis.