THE IMPACT OF SCHISTOCYTE DETECTION ON MORTALITY AND ORGAN FAILURE IN PATIENTS WITH SEPSIS

Area of Science:

• Hematology
• Critical Care Medicine
• Pathophysiology

Background:

• Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
• Schistocytes, or fragmented red blood cells, can arise from various pathological conditions, including microangiopathic hemolytic anemias.
• The clinical significance of schistocytes in sepsis remains incompletely understood.

Purpose of the Study:

• To investigate the prevalence of schistocytes in patients with sepsis.
• To determine the association between schistocyte presence and mortality in sepsis.
• To evaluate the relationship between schistocytes and organ failure severity in sepsis.

Main Methods:

• Retrospective observational study conducted at Shiga University of Medical Science Hospital.
• Inclusion of patients diagnosed with sepsis or septic shock between January 2015 and April 2021.
• Identification of schistocytes via daily hematological examinations and assessment of organ failure using Sequential Organ Failure Assessment (SOFA) scores.

Main Results:

• Schistocytes were detected in 41 out of 330 sepsis patients.
• Schistocyte presence significantly correlated with higher 90-day and 1-year mortality rates (48.7% and 68.2%, respectively).
• Patients with schistocytes exhibited higher SOFA scores, particularly for coagulation and renal dysfunction, and required more frequent red blood cell transfusions.

Conclusions:

• Schistocytes are significantly associated with increased long-term mortality and organ failure in sepsis.
• Detection of schistocytes may serve as a prognostic marker for sepsis severity.
• Identifying schistocytes could aid in guiding therapeutic strategies and improving sepsis management outcomes.