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Hypercoagulability in Septic Shock Patients With Thrombocytopenia

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Abstract
--------------e-pub(22.1.12)------------------
Background: Despite thrombocytopenia, patients with sepsis often experience hypercoagulability. However, limited information
is available on the prevalence and effect of hypercoagulability in patients with sepsis-induced thrombocytopenia. Hence, we
evaluated the prevalence of hypercoagulability and the association between hypercoagulability and clinical outcomes in septic
shock patients with thrombocytopenia. Methods: Thromboelastography (TEG) was performed prospectively in 1294 patients
with septic shock at the emergency department (ED) between January 2016 and December 2019. After excluding 405 patients
who did not require resuscitation, refused enrollment, or developed septic shock after ED presentation, 889 patients were
included. We defined thrombocytopenia as an admission platelet count lower than 150,000/ml according to SOFA score. We
defined hypocoagulability and hypercoagulability as coagulation index (CI)< 3 and >3 on TEG, respectively. Results: Of the 889
septic shock patients (mean age 65.6+ 12.7 years, 58.6% male), 473 (53.2%) had thrombocytopenia. Eighty-five (18.0%) patients
showed hypercoagulable TEG and73 (15.4%) patients showed hypocoagulable TEG. The hypercoagulable TEG group had a significantly
higher fibrinogen level and a lower 28-day mortality rate than the normal and hypocoagulable TEG groups (518 vs. 347
and 315 mg/dL; 7.1% vs. 21.1% and 36.8%, P < 0.01, respectively). In multivariate analysis, hypercoagulable TEG was associated
with a decreased mortality rate (odds ratio: 0.395; 95% confidence interval, 0.162-0.965). Conclusions: In septic shock patients
with thrombocytopenia, hypercoagulability was not uncommon. TEG can quickly distinguish the hypercoagulability and hypocoagulability
states and serve as a valuable tool for evaluating the degree and risk in septic shock patients with thrombocytopenia.
Author(s)
김상민김상일김원영김준성유지나홍석인
Issued Date
2021
Type
Article
Keyword
hypercoagulabilityseptic shockthrombocytopeniathromboelastography
DOI
10.1177/08850666211024188
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8292
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2539521610&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Hypercoagulability%20in%20Septic%20Shock%20Patients%20With%20Thrombocytopenia&amp;offset=0&amp;pcAvailability=true
Publisher
JOURNAL OF INTENSIVE CARE MEDICINE
Location
미국
Language
영어
ISSN
0885-0666
Citation Volume
1
Citation Number
1
Citation Start Page
138
Citation End Page
736
Appears in Collections:
Medicine > Medicine
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