scholarly journals Association Between Serum Procalcitonin Levels and Disseminated Intravascular Coagulation in Patients With Septic Shock

2021 ◽  
Author(s):  
Guang Fu ◽  
Xi-si He ◽  
Xiao-peng Cao ◽  
Hao-li Li ◽  
Hai-chao Zhan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Septic Shock ◽  
Electronic Medical Records ◽  
Disseminated Intravascular Coagulation ◽  
Medical Records ◽  
Operating Characteristic ◽  
Early Stage ◽  
Area Under The Curve ◽  
Intravascular Coagulation

Abstract Objectives: To investigated the relationships between procalcitonin (PCT) and disseminated intravascular coagulation (DIC) during septic shock. Methods: A retrospective study was performed, which included septic shock patients admitted into intensive care unit (ICU) from January 1, 2015 to December 31, 2018. DIC was defined as international society of thrombosis and homeostasis criteria (ISTH≥5). PCT was based on the first value after admission into ICU and the routine biochemical coagulation data based on the worst value extracted from electronic medical records within 24 hours on admission into ICU.Results: Among 2156 patients screened, 164 patients with septic shock were included in the finally analysis and 35.4% (58/164) of whom developed DIC after admission. PCT level was significantly 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, P <0.001). Multivariable logistic regression revealed that PCT (OR=1.011, 95% CI 1.006- 1.016, P<0.001) was associated with DIC during septic shock. Curve fitting showed a positive correlation between PCT and DIC. The Receiver Operating characteristic (ROC) curve suggested that the cut-off point for PCT to predict DIC during septic shock was 42.1ng/ml, with sensitivity 60.34%, specificity72.74% and the area under the curve (AUC) 0.701(95% CI [0.619-0.784], P<0.001). Interestingly, PCT increased early detection of DIC during septic shock compared with other risk factors(P=0.012)Conclusions: Our data suggest that PCT level over 42.1ng/ml on admission is associated with DIC during septic shock, and PCT is a potential predictive factor of DIC induced by septic shock at early stage.

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

2020 ◽  
Author(s):  
Guang Fu ◽  
Xi-si He ◽  
Hao-li Li ◽  
Hai-chao Zhan ◽  
Jun-fu Lu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Cohort Study ◽  
Disseminated Intravascular Coagulation ◽  
Area Under The Curve ◽  
Multivariable Logistic Regression Model ◽  
Intravascular Coagulation ◽  
The Relationship ◽  
Conventional Risk Factors

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.

scholarly journals Role of Thromboelastography as an Early Predictor of Disseminated Intravascular Coagulation in Patients with Septic Shock

2020 ◽  
Vol 9 (12) ◽  
pp. 3883
Author(s):  
Sang Min Kim ◽  
Sang-Il Kim ◽  
Gina Yu ◽  
June-Sung Kim ◽  
Seok In Hong ◽  
...  
Keyword(s):  
Septic Shock ◽  
Disseminated Intravascular Coagulation ◽  
Independent Predictor ◽  
Multivariable Analysis ◽  
Area Under The Curve ◽  
Maximal Amplitude ◽  
Resuscitation Orders ◽  
Intravascular Coagulation ◽  
Discriminating Power

(1) Background: The currently proposed criteria for diagnosing overt disseminated intravascular coagulation (DIC) are not suitable for early detection of DIC. Thromboelastography (TEG) rapidly provides a comprehensive assessment of the entire coagulation process and is helpful as a guide for correcting consumptive coagulopathy in sepsis-induced DIC. This study aimed to investigate the role of TEG in the prediction of DIC in patients with septic shock. (2) Methods: TEG was conducted prospectively in 1294 patients with septic shock at the emergency department (ED) between January 2016 and December 2019. After exclusion of 405 patients with “do not attempt resuscitation” orders, those refusing enrollment, and those developing septic shock after ED presentation, 889 patients were included. DIC was defined as an International Society on Thrombosis and Hemostasis score ≥ 5 points within 24 h. (3) Results: Of the 889 patients with septic shock (mean age 65.6 ± 12.7 years, 58.6% male), 158 (17.8%) developed DIC. TEG values, except lysis after 30 min, were significantly different between the DIC and non-DIC groups. Among the TEG values, the maximal amplitude (MA) had the highest discriminating power for DIC, with an area under the curve of 0.814. An MA < 60 indicated DIC with 79% sensitivity, 73% specificity, and 94% negative predictive value. Based on multivariable analysis, MA < 60 was an independent predictor of DIC (odds ratio 5.616 (95% confidence interval: 3.213–9.818)). (4) Conclusions: In patients with septic shock, the MA value in TEG could be a valuable tool for early prediction of DIC.

scholarly journals Prediction of anemia at delivery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Enav Yefet ◽  
Avishag Yossef ◽  
Zohar Nachum
Keyword(s):  
Risk Factors ◽  
Operating Characteristic ◽  
Complete Blood Count ◽  
Characteristic Curve ◽  
Secondary Analysis ◽  
Area Under The Curve ◽  
Iron Supplement ◽  
Independent Risk Factors ◽  
Operating Characteristic Curve ◽  
Study Database

AbstractWe aimed to assess risk factors for anemia at delivery by conducting a secondary analysis of a prospective cohort study database including 1527 women who delivered vaginally ≥ 36 gestational weeks. Anemia (Hemoglobin (Hb) < 10.5 g/dL) was assessed at delivery. A complete blood count results during pregnancy as well as maternal and obstetrical characteristics were collected. The primary endpoint was to determine the Hb cutoff between 24 and 30 gestational weeks that is predictive of anemia at delivery by using the area under the curve (AUC) of the receiver operating characteristic curve. Independent risk factors for anemia at delivery were assessed using stepwise multivariable logistic regression. Hb and infrequent iron supplement treatment were independent risk factors for anemia at delivery (OR 0.3 95%CI [0.2–0.4] and OR 2.4 95%CI [1.2–4.8], respectively; C statistics 83%). Hb 10.6 g/dL was an accurate cutoff to predict anemia at delivery (AUC 80% 95%CI 75–84%; sensitivity 75% and specificity 74%). Iron supplement was beneficial to prevent anemia regardless of Hb value. Altogether, Hb should be routinely tested between 24 and 30 gestational weeks to screen for anemia. A flow chart for anemia screening and treatment during pregnancy is proposed in the manuscript.Trial registration: ClinicalTrials.gov Identifier: NCT02434653.

scholarly journals Predictors of Disseminated Intravascular Coagulation in Patients with Septic Shock

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Diana J. Kelm ◽  
Juan Carlos Valerio-Rojas ◽  
Javier Cabello-Garza ◽  
Ognjen Gajic ◽  
Rodrigo Cartin-Ceba
Keyword(s):  
Septic Shock ◽  
Antiplatelet Therapy ◽  
Disseminated Intravascular Coagulation ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Model ◽  
Care Hospital ◽  
Clinical Predictors ◽  
Intravascular Coagulation ◽  
Early Goal Directed Therapy ◽  
Increased Risk

Purpose. The goal of this study was to identify potential clinical predictors for the development of disseminated intravascular coagulation (DIC) in patients with septic shock. Material and Methods. We performed a retrospective analysis of a cohort of adult (>18 years of age) patients with septic shock admitted to a medical ICU in a tertiary care hospital from July 2005 until September 2007. A multivariate logistic regression model was used to determine the association of risk factors with overt DIC. Results. In this study, a total of 390 patients with septic shock were analyzed, of whom 66 (17%) developed overt DIC. Hospital mortality was significantly greater in patients who developed overt DIC (68% versus 38%, P<0.001). A delay in the timing of antibiotics was associated with an increased risk of the development of overt DIC (P<0.001). Patients on antiplatelet therapy prior to hospital admission and who that received adequate early goal-directed therapy (EGDT) were associated with a decreased risk of overt DIC (P<0.001). Conclusions. In our cohort of patients with septic shock, there was a risk reduction for overt DIC in patients on antiplatelet therapy and adequate EGDT, while there was an increased risk of DIC with antibiotic delay.

scholarly journals Comparing the Clinical Characteristics and Mortality of Residential and Non-Residential Older People with COVID-19: Retrospective Observational Study

2022 ◽  
Vol 19 (1) ◽  
pp. 483
Author(s):  
Francesc X. Marin-Gomez ◽  
Jacobo Mendioroz-Peña ◽  
Miguel-Angel Mayer ◽  
Leonardo Méndez-Boo ◽  
Núria Mora ◽  
...  
Keyword(s):  
Risk Factors ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Fold Increase ◽  
The Elderly ◽  
Health Administration ◽  
Epidemic Outbreak ◽  
Risk Of Death ◽  
Using Data

Nursing homes have accounted for a significant part of SARS-CoV-2 mortality, causing great social alarm. Using data collected from electronic medical records of 1,319,839 institutionalised and non-institutionalised persons ≥ 65 years, the present study investigated the epidemiology and differential characteristics between these two population groups. Our results showed that the form of presentation of the epidemic outbreak, as well as some risk factors, are different among the elderly institutionalised population with respect to those who are not. In addition to a twenty-fold increase in the rate of adjusted mortality among institutionalised individuals, the peak incidence was delayed by approximately three weeks. Having dementia was shown to be a risk factor for death, and, unlike the non-institutionalised group, neither obesity nor age were shown to be significantly associated with the risk of death among the institutionalised. These differential characteristics should be able to guide the actions to be taken by the health administration in the event of a similar infectious situation among institutionalised elderly people.

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