Whole-blood hypocoagulable profile correlates with a greater risk of death within 28 days in patients with severe sepsis

Abstract

Background: Hypocoagulability and impaired platelet function have been associated with a high risk of death in sepsis. The aim of this cohort study was to determineROTEM®whether sep-sis-induced TIPLATE®, hypocoagulability and platelet dysfunction (assessed by and MUL-respectively) are increased in sepsis patients who died within 28 days after diagnosis compared with patients who died between 29 and 90 days after diagnosis. Methods: Consecutive patients admitted to the intensive care unit of Padova University Hospital from March 2015 to March 2018 for ROTEM®severe sepsis wereMULTIPLATE®considered. We collected blood samples from all patients to determine and parameters. Each enrolled patient underwent a 90-day follow-up and the mortality rate was recorded. Results: Of 120 patients, 36 (30%) died within 28 days post-diagnosis (Group A), 23 (19%) died between days 29 and 90 post-diagnosisROTEM®(Group B), and 61 (51%) were alive after 90 days (survivors). The clotting time in the test and clot formation time in the EXTEM test were significantly more prolonged in Group A than in B. Both groups showed aPLATE®significantly higher hypocoagulability than survivors in the EXTEM test. MULTI-platelet function analysis showed that platelet function was significantly lower in Group A than in Group B. Conclusions: The present study showed that the combination of thromboelastometry and impedance aggregometry may help identifying sepsis patients at high risk of short-term death. Larger studies are warranted to corroborate our results.