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Which Septic Shock Patients With Non-Overt DIC Progress to DIC After Admission? Point-of-Care Thromboelastography Testing.
- Source :
-
Shock (Augusta, Ga.) [Shock] 2022 Feb 01; Vol. 57 (2), pp. 168-174. - Publication Year :
- 2022
-
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.<br />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) score ≥ 5. The primary outcome was non-overt DIC at admission that met the ISTH DIC criteria within 3 days after admission.<br />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, P < 0.001; 13.6% vs. 27.0%, P = 0.008, 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 (P < 0.001). On multivariate analysis, an MA < 64 mm was independently associated with DIC development (odds ratio, 2.311; 95% confidence interval, 1.298-4.115).<br />Conclusions: DIC more often developed among those with admission ISTH scores ≥ 3 and was associated with higher mortality rates. An MA < 64 mm was independently associated with DIC development in septic shock patients.<br />Competing Interests: The authors report no funding and conflicts of interest.<br /> (Copyright © 2021 by the Shock Society.)
- Subjects :
- Aged
Blood Coagulation Tests methods
Blood Coagulation Tests statistics & numerical data
Cohort Studies
Disseminated Intravascular Coagulation diagnosis
Disseminated Intravascular Coagulation physiopathology
Female
Hospitalization statistics & numerical data
Humans
Male
Middle Aged
Point-of-Care Systems standards
Point-of-Care Systems statistics & numerical data
Prospective Studies
ROC Curve
Republic of Korea
Retrospective Studies
Shock, Septic blood
Thrombelastography methods
Thrombelastography statistics & numerical data
Disseminated Intravascular Coagulation diagnostic imaging
Shock, Septic complications
Thrombelastography standards
Subjects
Details
- Language :
- English
- ISSN :
- 1540-0514
- Volume :
- 57
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Shock (Augusta, Ga.)
- Publication Type :
- Academic Journal
- Accession number :
- 35025842
- Full Text :
- https://doi.org/10.1097/SHK.0000000000001847