Diagnostic utility of combined coagulation and inflammatory biomarkers in sepsis stratification: A retrospective...

The aim of this study is to evaluate the diagnostic utility of coagulation parameters-prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-Dimer (D-D), prothrombin time activity (PTA), and international normalized ratio (INR) -in combination with inflammatory markers, including procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), systemic inflammation index (SII), and lymphocyte-C-reactive protein ratio (LCR), for stratifying sepsis severity.

This retrospective study included 123 patients diagnosed with sepsis and confirmed by positive blood cultures between October 2020 and October 2024. A control group comprising 50 healthy individuals undergoing routine physical examinations was also included. Clinical data were collected and analyzed using SPSS 25.0. The sensitivity, specificity, receiver operating characteristic (ROC) curves, and area under the curve (AUC) values of each indicator were calculated to evaluate their diagnostic value.

No statistically significant differences were observed in baseline demographic or clinical characteristics between the sepsis and control groups (p > 0.05). Significant differences were identified between the groups in PT, APTT, D-D, PTA, INR, and CRP values (p < 0.05).The correlation coefficients between different grades of sepsis (shock and non-shock) and PT, APTT,DD,INR,PTA,LCR, CRP were r = 0.328,r = 0.254,r = 0.272,r = 0.347,r = -0.331,r = -0.179,r = 0.200, respectively. P < 0.05 is statistically significant,It is suggested that the classification is positively correlated with PT,APTT,DD,INR and CRP. PTA and LCR are negatively correlated, but the correlation in hierarchical diagnosis is low. Compared with sepsis group, the area under the curve (AUC) of coagulation index and inflammatory index in septic shock group was calculated. The area under the curve of PT in coagulation index was 0.695, the sensitivity was 53.2 %, and the specificity was 82.9 %. The area under the APTT curve was 0.651, the sensitivity was 66.0 %, and the specificity was 64.5 %. The area under the DD curve was 0.662, the sensitivity was 76.6 %, and the specificity was 57.9 %. Among the inflammatory indicators, the area under the CRP curve was 0.619, with a sensitivity of 63.8 % and a specificity of 63.2 %. ROC analysis revealed that the AUC of LCR in the septic shock group was 0.604, with a sensitivity of 66.0 % and specificity of 57.9 %. Combined detection of PT, LCR, and DD yielded an AUC of 0.8705, with a sensitivity of 74.5 % and specificity of 68.8 %.

Combined detection of coagulation markers such as PT with inflammatory markers including LCR, and DD may enhance the diagnostic accuracy for stratifying sepsis severity and identifying progression to septic shock.