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Hypercoagulability in Septic Shock Patients With Thrombocytopenia
Sang-Min Kim1, Sang-Il Kim2, Gina Yu3
1Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Journal of Intensive Care Medicine
|June 9, 2021
Summary
Hypercoagulability is common in septic shock patients with thrombocytopenia. This hypercoagulable state, identified by thromboelastography (TEG), is linked to lower mortality rates.
Area of Science:
- Critical Care Medicine
- Hematology
- Pathophysiology
Background:
- Sepsis often presents with thrombocytopenia, yet hypercoagulability can coexist.
- Limited data exists on the prevalence and impact of hypercoagulability in sepsis-induced thrombocytopenia.
Purpose of the Study:
- To determine the prevalence of hypercoagulability in septic shock patients with thrombocytopenia.
- To investigate the association between hypercoagulability and clinical outcomes, including mortality.
Main Methods:
- Prospective study of 889 septic shock patients in the emergency department.
- Thromboelastography (TEG) used to assess coagulation status; hypercoagulability defined as Coagulation Index (CI) > 3.
- Thrombocytopenia defined as a platelet count < 150,000/µl.
Main Results:
- 53.2% of patients had thrombocytopenia.
- 18.0% of patients exhibited hypercoagulability via TEG.
- Hypercoagulable patients had higher fibrinogen levels and significantly lower 28-day mortality (7.1%) compared to normal or hypocoagulable groups.
Conclusions:
- Hypercoagulability is a frequent finding in septic shock patients with thrombocytopenia.
- TEG is a valuable tool for rapid assessment of coagulation status and risk stratification.
- Hypercoagulable TEG was independently associated with decreased mortality.
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