ArticleInternal and emergency medicine2019
Prognostic value of sepsis-induced coagulation abnormalities: an early assessment in the emergency department.
Article in Internal and emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- D-dimer corrected for thrombin and plasmin generation is a strong predictor of mortality in patients with sepsis.Blood transfusion = Trasfusione del sangue · 2020Trial
- Recognizing Coagulation Disorders in Sepsis in the Emergency Room: A Narrative Review.Journal of clinical medicine · 2026Review
- Contact activation of coagulation in newly inserted indwelling catheters.Scientific reports · 2025Observational
- Machine learning-based nomogram for mortality risk stratification in cirrhotic patients with sepsis: a single-center predictive model.Frontiers in medicine · 2025Article
- The role of early changes in routine coagulation tests in predicting the occurrence and prognosis of sepsis.World journal of emergency medicine · 2025Article
- Article
- A single-center study of reference intervals for TAT, PIC, TM and t-PAIC in healthy older Chinese adults.Thrombosis journal · 2024Article
- Association between D-dimer to lymphocyte ratio and in hospital all-cause mortality in elderly patients with sepsis: a cohort of 1123 patients.Frontiers in cellular and infection microbiology · 2024Article
- Elevated plasma D-dimer levels are associated with the poor prognosis of critically ill children.Frontiers in pediatrics · 2022Article
- Cerebrovascular Events in Suspected Sepsis: Retrospective Prevalence Study in Critically Ill Patients Undergoing Full-Body Computed Tomography.Frontiers in neurology · 2022Article
- Performance of D-dimer for predicting sepsis mortality in the intensive care unit.Biochemia medica · 2021Article
- Plasma PCSK9 levels and sepsis severity: an early assessment in the emergency department.Clinical and experimental medicine · 2021Article
- D-Dimer Tests in the Emergency Department: Current Insights.Open access emergency medicine : OAEM · 2021Review
- Prediction of 90-Day Mortality among Sepsis Patients Based on a Nomogram Integrating Diverse Clinical Indices.BioMed research international · 2021Article
- Clinical Utility of Delta Lactate for Predicting Early In-Hospital Mortality in Adult Patients: A Prospective, Multicentric, Cohort Study.Diagnostics (Basel, Switzerland) · 2020Article
- Prognostic value of serial lactate levels in septic patients with and without shock.Internal and emergency medicine · 2019Article
- The Risk Factors of VTE and Survival Prognosis of Patients With Malignant Cancer: Implication for Nursing and Treatment.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
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16 authors.
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Abstract
To evaluate if the assessment of coagulation abnormalities at ED admission could improve prognostic assessment of septic patients. This report utilizes a portion of the data collected in a prospective study, with the aim to identify reliable biomarkers for an early sepsis diagnosis. In the period November 2011-December 2016, we enrolled 268 patients, admitted to our High-Dependency Unit with a diagnosis severe sepsis/septic shock. Study-related blood samplings were performed at ED-HDU admission (T0), after 6 h (T6) and 24 h (T24): D-dimer, thrombin-antithrombin complex (TAT) and prothrombin fragment F1 + 2 levels were analyzed. The primary end-points were day-7 and in-hospital mortality. Day-7 mortality rate was 16%. D-dimer (T0: 4661 ± 4562 µg/ml vs 3190 ± 7188 µg/ml; T6: 4498 ± 4931 µg/ml vs 2822 ± 5623 µg/ml; T24 2905 ± 2823 µg/ml vs 2465 ± 4988 µg/ml, all p < 0.05) and TAT levels (T0 29 ± 45 vs 22 ± 83; T6 21 ± 22 vs 15 ± 35; T24 16 ± 19 vs 13 ± 30, all p < 0.05) were higher among non-survivors compared to survivors. We defined an abnormal coagulation activation (COAG+) as D-dimer > 500 µg/ml and TAT > 8 ng/ml (for both, twice the upper normal value). Compared to COAG-, COAG+ patients showed higher lactate levels at the earliest evaluations (T0: 3.3 ± 2.7 vs 2.5 ± 2.3, p = 0.041; T6: 2.8 ± 3.4 vs 1.8 ± 1.6, p = 0.015); SOFA score was higher after 24 h (T24: 6.7 ± 3.1 vs 5.4 ± 2.9, p = 0.008). At T0, COAG+ patients showed a higher day-7 mortality rate (HR 2.64; 95% CI 1.14-6.11, p = 0.023), after adjustment for SOFA score and lactate level. Presence of abnormal coagulation at ED admission shows an independent association with an increased short-term mortality rate.
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