Role of coagulation function in bacterial bloodstream infection among malignant tumor patients

doi:10.3969/j.issn.1673-8640.2025.08.014

Abstract

Abstract:

Objective To investigate the diagnostic and prognostic value of coagulation indicators in patients with malignant tumors complicated with bacterial bloodstream infection （BSI）. Methods A total of 206 patients with malignant tumors complicated with BSI （positive group） and 238 patients with malignant tumors without BSI （control group） admitted to Fudan University Shanghai Cancer Center from January 2019 to December 2023 were enrolled. Basic information，pathogen infection status and coagulation function determination results of the patients were collected. The positive group patients were followed up and classified into good prognosis group （162 cases） and poor prognosis group （44 cases） based on their prognosis. Multivariate Logistic regression analysis was used to evaluate the influencing factors of BSI in patients with malignant tumors. Receiver operating characteristic （ROC） curve was used to evaluate the diagnostic efficacy of coagulation indicators for BSI in patients with malignant tumors. Results Prothrombin time （PT），activated partial thromboplastin time （APTT），thrombin time （TT），fibrinogen （Fib），D-dimer （DD），and fibrin （fibrinogen） degradation product （FDP） in the positive group were higher than those in the control group （P<0.05）. PT，TT，Fib，DD and FDP were risk factors for BSI in patients with malignant tumors （P<0.05）. The areas under curves of PT，TT，Fib，DD，FDP single and combined determinations for the diagnosis of BSI in patients with malignant tumors were 0.814，0.608，0.596，0.784，0.771 and 0.879，respectively. The age，PT，APTT and TT in poor prognosis group were higher than those in good prognosis group（P<0.001），and Fib was lower than that in good prognosis group （P<0.001）. Conclusions PT，TT，Fib，DD and FDP can be used to assist in the diagnosis of BSI in patients with malignant tumors，and the combined determination of the 5 indicators has better diagnostic efficacy. PT，APTT，TT and Fib are related to the prognosis of patients with malignant tumors complicated with BSI.

Key words: Coagulation function, Malignant tumor, Bloodstream infection

CLC Number:

R446.11

SHI Shaoxin, CHEN Xueting, XU Xiaofeng, LU Renquan, GUO Lin, ZHUANG Yihui. Role of coagulation function in bacterial bloodstream infection among malignant tumor patients[J]. Laboratory Medicine, 2025, 40(8): 804-809.

Figures/Tables 5

References 25

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细菌名称	菌株数/株	百分比/%
大肠埃希菌	64	27.95
肺炎克雷伯菌	36	15.72
铜绿假单胞菌	18	7.86
屎肠球菌	18	7.86
鲍曼不动杆菌复合群	9	3.93
阴沟肠杆菌复合群	8	3.49
金黄色葡萄球菌	8	3.49
黏质沙雷菌	6	2.62
表皮葡萄球菌	6	2.62
缓症链球菌	6	2.62
其他	50	21.83

细菌名称	菌株数/株	百分比/%
大肠埃希菌	64	27.95
肺炎克雷伯菌	36	15.72
铜绿假单胞菌	18	7.86
屎肠球菌	18	7.86
鲍曼不动杆菌复合群	9	3.93
阴沟肠杆菌复合群	8	3.49
金黄色葡萄球菌	8	3.49
黏质沙雷菌	6	2.62
表皮葡萄球菌	6	2.62
缓症链球菌	6	2.62
其他	50	21.83

组别	例数	性别（男/女）		年龄/岁		PT/s	APTT/s
阳性组	206	149/57		63.31±10.82		16.29±7.83	39.36±11.24
对照组	238	159/79		61.49±11.16		13.16±1.59	35.23±6.74
统计值		1.585		1.732		5.625	4.602
P值		0.208		0.084		<0.001	<0.001
组别	TT/s		Fib/（g·L^-1）		DD/（μg·mL^-1）		FDP/（μg·mL^-1）
阳性组	14.59±2.25		4.47±1.94		3.81（2.37，7.75）		11.09（6.87，22.63）
对照组	15.12±1.71		3.80±1.35		1.33（0.47，3.18）		3.66（2.00，9.47）
统计值	-2.789		4.150		10.313		9.847
P值	0.006		<0.001		<0.001		<0.001

组别	例数	性别（男/女）		年龄/岁		PT/s	APTT/s
阳性组	206	149/57		63.31±10.82		16.29±7.83	39.36±11.24
对照组	238	159/79		61.49±11.16		13.16±1.59	35.23±6.74
统计值		1.585		1.732		5.625	4.602
P值		0.208		0.084		<0.001	<0.001
组别	TT/s		Fib/（g·L^-1）		DD/（μg·mL^-1）		FDP/（μg·mL^-1）
阳性组	14.59±2.25		4.47±1.94		3.81（2.37，7.75）		11.09（6.87，22.63）
对照组	15.12±1.71		3.80±1.35		1.33（0.47，3.18）		3.66（2.00，9.47）
统计值	-2.789		4.150		10.313		9.847
P值	0.006		<0.001		<0.001		<0.001

组别	例数	性别		年龄/岁	PT/s	APTT/s
组别	例数	男/例	女/例	年龄/岁	PT/s	APTT/s
预后不良组	44	30	14	67.52±8.83	15.90（14.48，20.53）	47.60（34.20，59.65）
预后良好组	162	119	43	62.16±11.05	13.95（13.15，38.00）	35.20（30.03，44.25）
统计值		0.481		2.969	5.236	4.311
P值		0.488		0.003	<0.001	<0.001
组别	TT/s			Fib/（g·L^-1）	DD/（μg·mL^-1）	FDP/（μg·mL^-1）
预后不良组	16.00（15.03，17.65）			2.35（1.72，3.31）	4.75（2.67，9.39）	13.65（9.05，24.83）
预后良好组	14.45（13.53，15.58）			3.82（3.02，4.63）	4.08（2.23，6.04）	11.10（6.86，17.20）
统计值	5.300			-5.494	1.406	1.838
P值	<0.001			<0.001	0.160	0.066