Comparison Of Coagulation Function Changes Between Elderly And Young Adults With Sepsis

Objective: A retrospective analysis of the differences in the traditional coagulant parameters of Sepsis in different age groups.Methods:Collect relevant clinical data of patients who met the diagnostic criteria for sepsis admitted to the intensive care unit of the first affiliated hospital of China medical university from January 2015 to December 2016,including general basic information and coagulation indexes(platelet count,fibrinogen,D dimer,FDPs,PT,APTT)of the patients;The blood sampling time was immediately after diagnosis of sepsis and 1-5days after diagnosis.The patients were divided into three groups according to their age:young adults group(less than 60 years old),middle-aged and elderly group(60-75 years old)and elderly group(more than 75 years old).The differences among patients of different age groups were compared.SPSS24.0 software was applied to describe the statistics.Results: 1.This study included 121 patients,there were 34 persons in the youth group,39 persons in the middle-aged group and 48 persons in the old age group,the infection sites were mainly distributed in the abdominal cavity,lung and urinary system.There was no statistical difference in the general data such as infection site,APACHE II score,SOFA score,lymphocyte count,albumin level,and some basic diseases in the 121 patients of this study.The median time of ICU in the three groups was9 days? 6 days and 6 days respectively,the patients in the young adults group lived longer in ICU,and the old group had more women patients who suffered from Sepsis,The male-female ratio was 21:27 and the other two groups were: 25:9 and 23:16.2.There was no statistical difference in traditional coagulation indicators in different age groups:The PLT level goes down and then goes up,young adults group PLT level higher than the other two groups,older groups had a relatively small change,the distribution of PLT in the three groups showed statistical differences in the first day after diagnosis and the abnormal rate of the older group was lowest;The Fib level showed a trend of decreasing first and then eventually falling again,the level of Fib in the three groups was always higher than the normal level,the early Fib level in the young adults was higher than the other two groups,and the level of the old group was lower;The level of D-dimerand FDPs showed a trend of rising and then falling,and the peak time of the young adults was the earliest,the distribution of D-dimer in the three groups showed statistical difference in the second day after diagnosis,and the abnormal rate of the elderly group was lower than that of others,it was mainly moderately elevated(51.3%),and the group was mainly elevated(50%);The PT and APTT levels of the three groups were mainly extended in the first day after diagnosis,and the main performance in the group of young adults and the elderly group was moderately prolonged,with the incidence rate of 55.9%and 60.4% respectively,while the middle aged group mainly showed mild extension(41%),the APTT levels of the young and middle-aged groups were mainly characterized by mild prolongation,while the middle-aged group mainly showed moderate prolongation.Conclusion: 1.There was no statistical significant difference in traditional coagulation indicators in different age groups;2.The early PLT abnormality rate was low in the elderly patients with sepsis,the fibrinolytic index was increased slowly and the level was low,and the clotting time was mainly manifested as mild to moderate extension.