Title : A cohort study of the spectrum of coagulopathy in acute sepsis and its correlation with physiological scores and outcome
Purpose: To evaluate the spectrum of coagulopathy in acute sepsis and to correlate it with sequential physiological scores (SOFA & APACHE II) and compare the findings among survivors and non-survivors.
DESIGN: Prospective cohort
Methods: It is a prospective cohort study comparing the requirement of mechanical ventilation, ionotropic support, need of Intensive care, duration of hospitalization, SOFA and APACHE-II scores with various markers of coagulation and fibrinolysis among survivors and non-survivors of sepsis. The study is conducted at a tertiary care hospital where 60 cases of sepsis have been studied. Among them, 29 were culture positive and 32 were culture negative.
Results: The most common microbial pathogen causing sepsis was Klebsiella(21.65%) with the most common site being respiratory tract(45%). When we compared the coagulation profile in Survivors and Non-Survivors, all coagulation parameters showed statistically significant difference between the two groups. Here, AT III, Protein-C and Protein-S are significantly decreased in non-survivor group and APTT, PT, INR, TT, FDP, D-Dimer, S Fibrinogen are significantly increased in non-survivor group (p-value<0.05).
Conclusion: In addition to predictive scoring system(SOFA, APACHE II), derangements in coagulation parameters may be used as a predictive tool to determine outcome in terms of severity of the disease and mortality in sepsis.