Prognostic value of hemostasis-related parameters for prediction of organ dysfunction and mortality in sepsis

Abstract

Background/aim: Clinical manifestations of sepsis are not caused directly by the invading pathogens, but rather mostly by systemic inflammation that leads to activation of the coagulation system. The aim of this study was to determine whether levels of hemostasisrelated parameters measured in intensive care unit admissions are associated with mortality and severity in patients with sepsis.Materials and methods: Eighty-five patients who fulfilled criteria for a diagnosis of sepsis were included in our study. Platelet count, activated partial thromboplastin time (aPTT), prothrombin time (PT), thrombin time, D-dimer, and fibrinogen levels were determined within the first 24 h from sepsis onset. Differences between groups of septic patients were assessed by Mann-Whitney U test and Kruskal-Wallis test. Logistic regression analysis was performed to test the joint effect of different predictors.Results: Prolonged aPTT and PT with higher D-dimer concentrations in patients with sepsis are associated with more severe forms of the disease. aPTT was prolonged in nonsurvivors, while platelet count and fibrinogen levels were higher in survivors. Platelet count and aPTT ratio are independent predictors of fatal outcome in our logistic regression model. Conclusion:Hemostasis-related parameters have a significant impact on severity and outcome in sepsis.

The Utility of Acute‐Phase Proteins in the Assessment of Treatment Response in Dogs With Bacterial Pneumonia

“…54 Additionally, prolonged aPTT has been correlated with a worse prognosis in both humans and dogs with systemic inflammation or sepsis. 55,56 Initial radiographic findings were consistent with previously reported findings in dogs with BP. 2,3 The resolution of the alveolar lung pattern was followed during hospitalization and follow-up visits.…”

Diagnostic value of basic laboratory parameters for simple and perforated acute appendicitis: An analysis of 3392 cases (neutrophil-to-lymphocyte ratio, platelet count, mean platelet volume, serum bilirubin)

“…Platelet count is a well-known indicator of the severity of systemic infections. [26] However, data regarding the diagnostic value of PLT for acute appendicitis remains limited. Two recent studies that each included fewer than 260 patients similarly found that PLT had no diagnostic value for acute appendicitis.…”

Coagulation tests on admission correlate with mortality and morbidity in general ICU patients: An observational study

“…We have previously studied patients with severe sepsis or septic shock and demonstrated that both APTT and PT‐INR on admission to the ICU correlate with mortality . In another study on septic patients, it was shown that patients with increased PT‐INR and D‐dimer and prolonged APTT developed more severe organ failure . Several studies have been performed on trauma patients, and the findings indicate that low levels of fibrinogen and high levels of fibrin degradation products (FDP), D‐dimer and PT‐INR, are associated with increased mortality .…”

“…7 In another study on septic patients, it was shown that patients with increased PT-INR and D-dimer and prolonged APTT developed more severe organ failure. 8 Several studies have been performed on trauma patients, and the findings indicate that low levels of fibrinogen and high levels of fibrin degradation products (FDP), D-dimer and PT-INR, are associated with increased mortality. [9][10][11][12][13] In an unselected general ICU population in China researchers investigated the correlation between mortality and PLC, APTT, PT-INR, D-dimer, fibrinogen and FDP at admission to the ICU.…”