ArticleIntensive care medicine2012
Persistent hypocoagulability in patients with septic shock predicts greater hospital mortality: impact of impaired thrombin generation.
Article in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Utility of thromboelastography and/or thromboelastometry in adults with sepsis: a systematic review.Critical care (London, England) · 2014Pooled it
- Viscoelastic testing: Transforming hemostasis management in patients in the medical intensive care unit.World journal of critical care medicine · 2026Review
- 101 machine learning algorithms for predicting mortality in critically ill patients with spinal cord injury and sarcopenia: a multi-database study.BMC medical informatics and decision making · 2026Observational
- Early Platelet Dysfunction in Sepsis: An ICU Pilot Study.Pathogens (Basel, Switzerland) · 2026Observational
- ACT001 improved cardiovascular function in septic mice by inhibiting the production of proinflammatory cytokines and the expression of JAK-STAT signaling pathway.Frontiers in pharmacology · 2023Article
- Role of thromboelastography in the evaluation of septic shock patients with normal prothrombin time and activated partial thromboplastin time.Scientific reports · 2021Observational
- Role of a thrombin generation assay in the prediction of infection severity.Scientific reports · 2021Article
- Hypocoagulable Tendency on Thromboelastometry Associated With Severity and Anticoagulation Timing in Pediatric Septic Shock: A Prospective Observational Study.Frontiers in pediatrics · 2021Article
- Thromboelastography Profiles of Critically Ill Patients With Coronavirus Disease 2019.Critical care medicine · 2020Article
- Thromboelastography Detects Possible Coagulation Disturbance in Pediatric Patients with Portal Cavernoma.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2020Article
- Enigmatic role of coagulopathy among sepsis survivors: a review of coagulation abnormalities and their possible link to chronic critical illness.Trauma surgery & acute care open · 2020Review
- Consumptive coagulopathy is associated with organ dysfunction during PICS.American journal of physiology. Lung cellular and molecular physiology · 2019Article
- Thromboelastography and rotational thromboelastometry for the surgical intensivist: A narrative review.The journal of trauma and acute care surgery · 2019Review
- Neutrophil extracellular trap-microparticle complexes enhance thrombin generation via the intrinsic pathway of coagulation in mice.Scientific reports · 2018Article
- Thromboelastometry for diagnosis of neonatal sepsis-associated coagulopathy: an observational study.European journal of pediatrics · 2018Observational
- The effect of sepsis and its inflammatory response on mechanical clot characteristics: a prospective observational study.Intensive care medicine · 2016Observational
- Causes and consequences of coagulation activation in sepsis: an evolutionary medicine perspective.BMC medicine · 2015Review
- Thromboelastography in patients with severe sepsis: a prospective cohort study.Intensive care medicine · 2015Observational
- Tromboelastography: variability and relation to conventional coagulation test in non-bleeding intensive care unit patients.BMC anesthesiology · 2015Article
- Bacterial RTX toxins allow acute ATP release from human erythrocytes directly through the toxin pore.The Journal of biological chemistry · 2014Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSepsis induces hypercoagulability, hypofibrinolysis, microthrombosis, and endothelial dysfunction leading to multiple organ failure. However, not all studies reported benefit from anticoagulation for patients with severe sepsis, and time courses of coagulation abnormalities in septic shock are poorly documented. Therefore, the aim of this prospective observational cohort study was to describe the coagulation profile of patients with septic shock and to determine whether alterations of the profile are associated with hospital mortality.
methodsThirty-nine patients with septic shock on ICU admission were prospectively included in the study. From admission to day 7, analytical coagulation tests, thrombin generation (TG) assays, and thromboelastometric analyses were performed and tested for association with survival.
resultsPatients with septic shock presented on admission prolongation of prothrombin time, activated partial thromboplastin time (aPTT), increased consumption of most procoagulant factors as well as both delay and deficit in TG, all compatible with a hypocoagulable state compared with reference values (P < 0.001). Time courses revealed a persistent hypocoagulability profile in non-survivors as compared with survivors. From multiple logistic regression, prolonged aPTT (P = 0.007) and persistence of TG deficit (P = 0.024) on day 3 were strong predictors of mortality, independently from disease severity scores, disseminated intravascular coagulation score, and standard coagulation tests on admission.
conclusionsPatients with septic shock present with hypocoagulability at the time of ICU admission. Persistence of hypocoagulability assessed by prolonged aPTT and unresolving deficit in TG on day 3 after onset of septic shock is associated with greater hospital mortality.
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