Factors Associated with Mortality Outcomes of Patients with Disseminated Intravascular Coagulation resulting from Septicemia: A Single Center
Keywords:
Disseminated Intravascular Coagulation (DIC), Coagulopathy, Septicemia, Red Blood Cell Transfusion, Cryoprecipitate TransfusionAbstract
Background: Disseminated intravascular coagulation (DIC) acquired from sepsis is a life-threatening condition which results in high mortality rates. The basic knowledge of epidemiology and the related factors causing morbidity and mortality can help physicians to recognize symptoms as well as provide proper management to decrease death rates. Objective: The aim of the study was to determine prevalence of DIC among patients with septicemia and factors associated with mortality outcomes. Materials and Methods: The medical records of 205 septic patients from 2011 to 2015 at HRH Princess Maha Chakri Sirindhorn Medical Center were gathered, reviewed, and analyzed as a retrospective study. Results: According to information obtained from 205 medical records, the median age of the patients was 68 years (range, 20-104). One-hundred and four patients were female (50.7%) and 101 patients (49.3%) were males. The blood cultures were positive for bacteria in 68.80% of cases. Urinary tract infection was the most common followed in rank by those of the respiratory tract, intra-abdominal area, skin and central nervous system. Thirty-nine of the 205 patients (19.0%) developed DIC. Multivariate analyses revealed significant associations with mortality within 28 days of hospital admission for patients presenting stage 4 chronic kidney disease (CKD) (p = 0.002), simple DIC score ≥ 2 at; diagnosis (p = 0.019) and 28 days of hospitalization (p < 0.001). Seventeen patients of the 39 (43.6%) diagnosed with DIC expired. Conclusion: A high mortality rate was observed among patients who developed sepsis with concurrent DIC. Patients presenting CKD stage 4, high level of simple DIC score at admission or 28 days of hospitalization were associated with higher mortality outcomes.
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