Analysis of the diagnostic value of coagulation markers and coagulation function indices on the occurrence of DIC in sepsis and its prognosis
Main Article Content
Keywords
sepsis, coagulation markers, coagulation indicators, diagnostic value, DIC, prognosis
Abstract
Sepsis is a life-threatening condition that has the potential to multiple organ dysfunction and mortality. One of its frequent complications is disseminated intravascular coagulation (DIC), characterized by hyperactive clotting mechanisms that cause widespread clot formation and tissue damage. This study aimed to investigate early diagnostic markers of sepsis-associated DIC by comparing inflammatory factor levels, 28-day survival rates, coagulation function, and markers between patients with sepsis (non-DIC group) and those with sepsis-induced DIC (DIC group). The study analyzed the diagnostic efficacy of coagulation function and markers in predicting the occurrence and prognosis of sepsis-associated DIC, presenting survival curves. Results indicated significantly increased levels of APTT, TAT, tPAIC, PIC, and sTM in the DIC group compared to the non-DIC group. Sequential Organ Failure Assessment (SOFA) scores on days 1, 3, and 7 were notably lower in the non-DIC group. Correlation analysis revealed positive associations between PT, APTT, TAT, tPAIC, PIC, sTM levels, and SOFA scores, as well as negative associations with Fib and SOFA scores. Survival curves showed substantially lower mortality rates in the non-DIC group, highlighting significant survival disparities between groups. Combining all four coagulation indicators (TAT+ tPAIC + PIC + sTM) showed promising diagnostic value in evaluating disease severity, early DIC diagnosis, and sepsis prognosis.
References
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2. DeMerle KM, Angus DC, Baillie JK, Brant E, Calfee CS, Carcillo J, et al. Sepsis subclasses: A framework for development and interpretation. Crit Care Med. 2021;49(5):748–59. 10.1097/CCM.0000000000004842
3. Oczkowski S, Alshamsi F, Belley-Cote E, Centofanti JE, Moller MH, Nunnaly ME, et al. Surviving sepsis campaign guidelines 2021: Highlights for the practicing clinician. Pol Arch Intern Med. 2022;132(7–8):16290. 10.20452/pamw.16290
4. Kingren MS, Starr ME, Saito H. Divergent sepsis pathophysiology in older adults. Antioxid Redox Sign. 2021;35(16):1358–75. 10.1089/ars.2021.0056
5. Yang K, Chen JQ, Wang T, Zhang Y. Pathogenesis of sepsis--associated encephalopathy: More than blood-brain barrier dysfunction. Mol Biol Rep. 2022;49(10):10091–9. 10.1007/s11033-022-07592-x
6. Iba T, Levi M, Thachil J, Levy JH. Disseminated intravascular coagulation: The past, present, and future considerations. Semin Thromb Hemost. 2022;48(08):978–87. 10.1055/s-0042-1756300
7. Popescu NI, Lupu C, Lupu F. Disseminated intravascular coagulation and its immune mechanisms. Blood. 2022;139(13):1973–86. 10.1182/blood.2020007208
8. Schizas N, Nazou G, Antonopoulos C, Angouras DC. Disseminated intravascular coagulation post endovascular aortic repair. Vasc Endovasc Surg. 2023;57(7):738–48. 10.1177/15385744231165231
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13. Jacobi J. The pathophysiology of sepsis-2021 update: Part 2, organ dysfunction and assessment. Am J Health-Syst Ph. 2022;79(6):424–36. 10.1093/ajhp/zxab393
14. Bateman RM, Sharpe MD, Jagger JE, Ellis CG, Solé-Violán J, López-Rodríguez M, et al. 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15–18 March 2016. Crit Care (London, England). 2016;20(Suppl 2):94.
15. Lee YT, Wang CC, Li CF, Chen HY, Liao HH, Lin CC. Utility of acute physiology and chronic health evaluation (APACHE II) in predicting mortality in patients with pyogenic liver abscess: A retrospective study. J Clin Med. 2021;10(12):2644. 10.3390/jcm10122644
16. Qiu X, Lei YP, Zhou RX. SIRS, SOFA, qSOFA, and NEWS in the diagnosis of sepsis and prediction of adverse outcomes: A systematic review and meta-analysis. Expert Rev Anti-Infe. 2023;21(8):891–900. 10.1080/14787210.2023.2237192
17. Adelborg K, Larsen JB, Hvas AM. Disseminated intravascular coagulation: Epidemiology, biomarkers, and management. Brit J Haematol. 2021;192(5):803–18. 10.1111/bjh.17172
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19. Joffre J, Hellman J. Oxidative stress and endothelial dysfunction in sepsis and acute inflammation. Antioxid Redox Sign. 2021;35(15):1291–307. 10.1089/ars.2021.0027
20. Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, et al. Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021;49(11):E1063-E1143.
21. Liu H, Zhang LM, Xu FS, Li SJ, Wang ZC, Han DD, et al. Establishment of a prognostic model for patients with sepsis based on SOFA: A retrospective cohort study. J Int Med Res. 2021;49(9):3000605211044892. 10.1177/03000605211044892
22. Erdogan M, Findikli HA. Novel biomarker for predicting sepsis mortality: Vitamin D receptor. J Int Med Res. 2021;49(8):3000605211034733. 10.1177/03000605211034733
23. Unar A, Bertolino L, Patauner F, Gallo R, Durante-Mangoni E. Pathophysiology of disseminated intravascular coagulation in sepsis: A clinically focused overview. Cells-Basel. 2023;12(17):2120. 10.3390/cells12172120
24. Comerford C, Glaveyz S, O’Sullivan JM, Quinn J. Potential mechanisms of resistance to current antithrombotic strategies in Multiple Myeloma. Cancer Drug Resist. 2022;5(1):214–28. 10.20517/cdr.2021.115
25. Halpin DMG, Criner GJ, Papi A, Singh D, Anzueto A, Martinez FJ, et al. Global initiative for the diagnosis, management, and prevention of chronic obstructive lung disease. The 2020 GOLD Science Committee Report on COVID-19 and Chronic Obstructive Pulmonary Disease. Am J Resp Crit Care. 2021;203(1):24–36. 10.1164/rccm.202009-3533SO
26. Mazzolai L, Ageno W, Alatri A, Bauersachs R, Becattini C, Brodmann M, et al. Second consensus document on diagnosis and management of acute deep vein thrombosis: Updated document elaborated by the ESC Working Group on aorta and peripheral vascular diseases and the ESC Working Group on pulmonary circulation and right ventricular function. Eur J Prev Cardiol. 2022;29(8):1248–63. 10.1093/eurjpc/zwab088
27. Umemura Y, Nishida T, Yamakawa K, Ogura H, Oda J, Fujimi S. Anticoagulant therapies against sepsis-induced disseminated intravascular coagulation. Acute Med Surg. 2023;10(1):e884. 10.1002/ams2.884
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Published
Sep 1, 2024
Article Details
How to Cite
Fang, X., Fu, W., Xu, L., & Qiu, Y. (2024). Analysis of the diagnostic value of coagulation markers and coagulation function indices on the occurrence of DIC in sepsis and its prognosis. Allergologia Et Immunopathologia, 52(5), 65-72. https://doi.org/10.15586/aei.v52i5.1119
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How to Cite
Fang, X., Fu, W., Xu, L., & Qiu, Y. (2024). Analysis of the diagnostic value of coagulation markers and coagulation function indices on the occurrence of DIC in sepsis and its prognosis. Allergologia Et Immunopathologia, 52(5), 65-72. https://doi.org/10.15586/aei.v52i5.1119