Relationship between coagulation disorders and severity and prognosis in severe sepsis

Objective To explore the relationship between coagulation disorders and severity and prognosis in severe sepsis. Methods Six hundred and ninety-four sepsis patiens with acute organ failures from 20 university hospitals were collected. Patients were divided into two groups according to survival(n=239) or death(n=277). Platelets and five coagulation markers were measured at the admission day. The diagnosis of severe sepsis was made according to the definitions for sepsis and organ failure of ACCP/SCCM. The severity of illness was determined by APACHE-Ⅱ score.The differences of coagulation markers between the two groups were analyzed,and the relationship between the coagulation markers and APACHE-Ⅱscore were studied. Results Plateletcount was decreased and D-dimer elevated obviously in the death group (P0.05). Prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT) were prolonged in the death group(P0.05). The APACHE-Ⅱscore of the death group was much higher than that of the survival group(P0.05).Conclusion Platelet count and prothrombin time(PT), actirated partial thrombo plastin time(APTT), thrombin time(TT) is associated with the prognosis and severity of severe sepsis. Restoration of the disrupted coagulantion pathways may improve the prognosis of severe sepsis.