Effect of coagulation disorders on score of Activity of Daily Living in patients with heat stroke

Objective To investigate the correlation between the change of coagulation function and change of score of Activity of Daily Living(ADL)at one week after hospital admission in patients with heat stroke. Methods The changes of coagulation indexes measured at the primary time(X)and 6 to 8 h after the onset of the disease(X_r)in 62 patients with heat stroke were analyzed retrospectively. The peak value(X_p), retest variation(△X)and abnormal duration(DT_x)of each index were observed, including peripheral blood platelet count(PLT), prothrombin time(PT), thrombin time(TT), activated partial thromboplastin time(APTT), fibrinogen(Fib)and D-dimer(D-D), and ADL was also collected at one week after hospital admission. The patients were divided into mild and moderate ADL injury group(n=37)and severe ADL injury group(n=35)according to the level of ADL. Student-t test was used to compare the changes of coagulation indexes between the two groups. Pearson and Spearman correlation analysis were used to evaluate the correlation between ADL and coagulation function indexes. Receiver operating characteristic(ROC)curve of relevant coagulation - indexes was drawn, and the area under curve(AUC)was used to evaluate the efficacy in predicting ADL damage. Results There were significant differences in PLT, PLT_r, △PT, TT, TT_r, DT_TT, Fib_r, DT_D-D, PTL_p, DT_PTL, PT, PT_r, PT_p, DT_PT, APTT_p, Fib, △Fib, DT_Fib, D-D, D-D_r and D-D_p between two groups(P<0.05 or P<0.01). ADL was positively correlated with PLT, PLT_r, PLT_p, Fib, Fib_r and Fib_p(P<0.01), and was negatively correlated with △PT, PT, PT_r, PT_p, TT, TT_r, TT_p, D-D, D-D_r, D-D_p, APTT_p, △TT, △D-D and DT_x of all the observation indexes(P<0.01). Fib was better than PLT in predicting mild or moderate injury of ADL, and D-D was more effective than PT and TT in predicting severe injury of ADL. Conclusion There is a significant correlation between ADL at one week after hospital admission and coagulation function in survivors with heat stroke. Coagulation disorders can determine the prognosis of neurological function, and Fib and D-D show higher predictive values for ADL impairment.