Serum procalcitonin levels predict disseminated intravascular coagulation in patients with sepsis shock: A retrospective cohort study

Abstract

Background Complication of disseminated intravascular coagulation (DIC) is a determinant of the prognosis in patients with sepsis shock. Procalcitonin (PCT) has been advocated as a marker of bacterial sepsis. The purpose of this study was to evaluate the relationship between serum PCT levels and DIC with sepsis shock Methods A cohort study was designed which included patients that admitted in intensive care unit (ICU) between January 1, 2015 and December 31, 2018 and the follow-up to discharge. 164 septic shock patients were divided into DIC and non-DIC groups according to international society of thrombosis and homeostasis (ISTH). PCT was measured at the admission to ICU, and all the participants received routine biochemical coagulation test subsequently. Results PCT levels were considerably higher in septic shock patients who developed DIC than those who did not (54.6[13.6–200]vs12.6[2.4–53.3]ng/ml), respectively, P < 0.001). Multivariable logistic regression model revealed that PCT level was significantly associated with risk of DIC independent of conventional risk factors. In addition, curve fitting showed a linear relationship between PCT and DIC score. The Receiver Operating characteristic(ROC) curve suggested that the optimal cut-off point for PCT to predicting DIC induced by septic shock was 42.0 ng/ml, and the area under the curve (AUC) was 0.701(95% CI [0.619–0.784], P < 0.001). More importantly, incorporating PCT with other risk factors into the prediction model significantly increased the AUC for prediction of DIC induced by sepsis shock (0.801vs 0.706; P = 0.012). Conclusions Our study suggests that PCT levels on admission is significantly and independently associated with DIC development subsequently with septic shock, combining PCT levels with other risk factors could significantly improve the prediction of DIC induced by sepsis shock.