Journal of Turkish Clinical Biochemistry

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August 01, 2024
JTCB. 2024 Aug 1; 22 (2) : 063-071
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Disseminated Intravascular Coagulation Score and Mortality in Adult Sepsis Patients

1 Ege Üniversitesi Tıp Fakültesi, İç Hastalıkları Anabilim Dalı/ Yoğun Bakım Bilim Dalı, İzmir, Türkiye
2 Ege Üniversitesi Tıp Fakültesi, İç Hastalıkları, İzmir, Türkiye
3 Kağızman Devlet Hastanesi, İç Hastalıkları, Kars, Türkiye
4 Ege Üniversitesi Tıp Fakültesi, Klinik Biyokimya Bilim Dalı, İzmir, Türkiye
5 Ege Üniversitesi Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı Hematoloji Bilim Dalı, İzmir, Türkiye
6 Ege Üniversitesi Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı, Tıbbi Onkoloji Bilim Dalı, İzmir, Türkiye
7 Torbalı Devlet Hastanesi, İç Hastalıkları, İzmir, Türkiye

Abstract

Aim: In the present study, we aimed to evaluate the association between disseminated intravascular coagulation (DIC) score and mortality among adult sepsis patients in intensive care unit (ICU).

Material and Methods: In this retrospective cohort study, two hundred and twenty-four patients were included. Demographic characteristics, clinical data and laboratory results were evaluated. The relationship between continuous variables was analyzed with Spearman's rank correlation coefficient. Risk factors for the development of DIC were investigated by binary logistic regression analysis using the Bakward Wald method. The sequential organ failure assessment (SOFA) score and the International Society on Thrombosis and Hemostasis DIC score were evaluated by ROC analysis to predict mortality. Youden J index was used to determine the threshold value. p<0.05 was considered statistically significant.

Results: Sepsis associated overt DIC developed in 34.8% (n=78) of the patients. Mortality in patients who developed sepsis associated overt DIC (75.6%) was significantly higher than those who did not (41.1%), p<0.001. Albumin (r=-0.295), neutrophil (-0.282) and lymphocyte count (-0.247) were negatively correlated with DIC score, p<0.001 for all; whereas SOFA score (r=0.413, p<0.001), lactate (r=0.196, p=0.021) and procalcitonin levels (r=0.209, p=0.022) were positively correlated. Presence of hematologic malignancy, acute kidney injury and SOFA scores on admission were determined as risk factors for developing DIC. When SOFA score and DIC score were compared with each other by ROC analysis in terms of predicting mortality, no significant difference was found (p=0.078).

Conclusion: In conclusion, the association of high SOFA score with mortality is emphasized in guidelines in the literature. In addition, our study demonstrates the association of DIC score with mortality by comparing it with SOFA score.

Citation

Bozgul, Sükriye Miray Kilincer, Merve Doğru Efgan, Zehra Tuba Karaman, Rabia Yelli, Hande Dik Avcı, Güneş Ak, Ajda Güneş, Caner Acar, İlkçe Akgün Kurtulmuş, and Devrim Bozkurt. 2024. “Disseminated Intravascular Coagulation Score and Mortality in Adult Sepsis Patients”. Journal of Turkish Clinical Biochemistry 22 (2):063-071. https://turkclinbiochem.org/index.php/pub/article/view/488.

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