Sepsis-induced coagulopathy and its association with mortality in patients with sepsis and septic shock

Abstract

OBJECTIVES: Sepsis-induced coagulopathy (SIC) is a common complication in patients with sepsis and septic shock. Early detection of SIC is crucial for timely intervention, as it can significantly impact patient outcomes. This study aims to evaluate the prevalence of SIC and its impact on the 28-day mortality rate in patients with sepsis and septic shock. METHODS: A single-center retrospective observational cohort study was conducted in Vietnam from January 2021 to August 2024. Adult patients diagnosed with sepsis or septic shock who were admitted to the intensive care unit within 24 h of initial presentation were included. Patients with do-not-resuscitate orders, coagulopathy, malignant blood disorders, incomplete data, or refusal of treatment were excluded. SIC scores were assessed, and 28-day mortality rates were recorded. RESULTS: A total of 340 patients were included, with 216 (63.5%) exhibiting SIC (SIC score ≥4). The mean age of patients was 69.01 ± 17.04 years, and the majority were male (61.5%). Septic shock accounted for 79.7% of the cases. SIC patients had significantly higher mortality rates at both 4 days (17.6% vs. 4.8%, P = 0.001) and 28 days (40.3% vs. 24.4%, P = 0.005). Nonsurvivors exhibited higher SIC (73.9% vs. 57.9%, P = 0.003) and had worse disease severity scores. Multivariate analysis confirmed that SIC score ≥4 was strongly associated with increased 28-day mortality (odds ratio 1.799, P = 0.033). CONCLUSIONS: The prevalence of SIC is high in patients with sepsis and septic shock, especially in our cohorts. SIC score ≥4 is also a strong and independent predictor for 28-day mortality.