Which Septic Shock Patients With Non-Overt DIC Progress to DIC After Admission? Point-of-Care Thromboelastography Testing.
Shock
; 57(2): 168-174, 2022 02 01.
Article
em En
| MEDLINE
| ID: mdl-35025842
ABSTRACT
BACKGROUND:
Disseminated intravascular coagulation (DIC) is a life-threatening complication of septic shock; however, risk factors for its development after admission are unknown. Thromboelastography (TEG) can reflect coagulation disturbances in early non-overt DIC that are not detected by standard coagulation tests. This study investigated the risk factors including TEG findings as early predictors for DIC development after admission in septic shock patients with non-overt DIC.METHODS:
This retrospective observation study included 295 consecutive septic shock patients with non-overt DIC at admission between January 2016 and December 2019. DIC was defined as an International Society on Thrombosis and Hemostasis (ISTH) scoreâ≥â5. The primary outcome was non-overt DIC at admission that met the ISTH DIC criteria within 3âdays after admission.RESULTS:
Of the 295 patients with non-overt DIC, 89 (30.2%) developed DIC after admission. The DIC group showed a higher ISTH score and 28-day mortality rate than the non-DIC group (2 vs. 3, Pâ<â0.001; 13.6% vs. 27.0%, Pâ=â0.008, respectively). The DIC rate increased with the ISTH score (7.7%, 13.3%, 15.8%, 36.5%, and 61.4% for scores of 0, 1, 2, 3, and 4, respectively). Among TEG values, the maximum amplitude (MA) was higher in the non-DIC group (Pâ<â0.001). On multivariate analysis, an MAâ<â64âmm was independently associated with DIC development (odds ratio, 2.311; 95% confidence interval, 1.298-4.115).CONCLUSIONS:
DIC more often developed among those with admission ISTH scoresâ≥â3 and was associated with higher mortality rates. An MAâ<â64âmm was independently associated with DIC development in septic shock patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Choque Séptico
/
Tromboelastografia
/
Coagulação Intravascular Disseminada
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Shock
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article