OBJECTIVE  To investigate coagulation dysfunction and abnormal expression of serum heparin-binding protein （HBP）, growth differentiation factor-15 （GDF-15） and tumor necrosis factor-α （TNF-α） in patients with sepsis, as well as the predictive value of these markers for outcomes of patients, so as to provide clinical references.

METHODS  A total of 122 patients with sepsis admitted to Xingtai Central Hospital from Apr. 2020 to Apr. 2022 were selected as the sepsis group, while 60 healthy individuals undergoing physical examinations in the hospital during the same period served as the control group. Expression levels of serum HBP, GDF-15 and TNF-α and coagulation function markers activated partial thromboplastin time （APTT）, prothrombin time （PT） were measured. Based on the outcomes after 28 days, patients were divided into a death group （32 cases） and a survival group （90 cases）. Receiver operating characteristic （ROC） curve analysis was used to evaluate the predictive value of serum HBP, GDF-15, TNF-α, APTT and PT for outcomes of patients.

RESULTS  The levels of HBP, GDF-15, TNF-α, PT and APTT in the sepsis group were （54.40 ± 6.54）, （1 477.89 ± 162.53）, （43.13 ± 5.48） pg/ml, （15.46 ± 1.73） and （35.14 ± 4.95） s, respectively, which were significantly higher than those in the control group （P＜0.001）. The levels of HBP, GDF-15, TNF-α, PT and APTT in the death group were （59.67 ± 4.31）, （1 608.29 ± 116.55）, （47.60 ± 4.85） pg/ml, （17.31 ± 1.91） and （39.33 ± 4.57） s, respectively, which were significantly higher than those in the survival group （P＜0.001）. ROC curve analysis revealed that the areas under the curve （AUC） for predicting poor prognosis by HBP, GDF-15, TNF-α, PT and APTT were 0.819 （95%CI: 0.730−0.909）, 0.817 （95%CI: 0.738−0.896）, 0.838 （95%CI: 0.762−0.915）, 0.810 （95%CI: 0.710−0.911） and 0.840 （95%CI: 0.758−0.921）, respectively.

CONCLUSIONS  Compared with healthy individuals, patients with sepsis exhibit coagulation abnormalities and abnormally elevated expression levels of serum HBP, GDF-15 and TNF-α. The coagulation abnormalities and the expression of serum HBP, GDF-15 and TNF-α are correlated with disease severity and prognosis, which demonstrate certain predictive value for prognosis. And they can be used as markers for clinical judgment of the severity and prognosis of the disease.