Clinical significance of changes in coagulation function and its prognosis in patients with fungemia / 临床检验杂志

ABSTRACT

Objective To investigate the changes of blood related parameters and coagulation function indicators in patients with funge-mia during hospitalization,and analyze the clinical significance of these changes and their impact on the patients'prognosis.Methods The patients with positive fungus blood culture for the first time and diagnosed as fungal bloodstream infection during December 2018 and October 2022 were retrospectively analyzed.Their blood related parameters and coagulation function indicators at admission and the time of positive blood culture were collected,and the differences of these clinical parameters were analyzed.The patients were divided into the survival group and death group based on their prognosis,and the differences in clinical parameters between the two groups were compared using the Mann-Whitney U test.The Logistic regression analysis was used to analyze the risk factors related to death.Results A total of 87 patients were enrolled in the study.The patients'results of monocyte count,lymphocyte count,and platelet(PLT)at the time of positive blood culture were significantly lower than those at admission(P＜0.001),while the levels of platelet-associated pa-rameters MPV and PDW were significantly increased(P＜0.05).The levels of coagulation function indicators such as PT,APTT,and D-dimer at the time of positive blood culture were significantly higher than those at admission(P＜0.05).Compared with the the surviv-al group,the peripheral blood PLT count in the death group at the time of positive blood culture was significantly reduced(P=0.022),while the PT,APTT and TT levels were significantly increased(P＜0.05).Logistic regression analysis showed that the death of patients was significantly correlated with the lower level of PLT(OR=1.46,95％CI:1.08-1.97,P=0.01).Conclusion The fungal infection in hospitalized patients can lead to a decrease in PLT count and the prolongation of PT and APTT.Low levels of PLT are associated with the patients'prognosis,and monitoring its changes can assist in assessing the patients'conditions and prognosis.