Correlation between Hemostasis Profile and Sepsis Outcome

Sisi Melansi, Eny Rahmawati, Susilawati Susilawati

Abstract


Sepsis is an organ dysfunction caused by infection. Excessive cytokine activation, which causes hemostasis disorder is
rated by Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), fibrinogen, and D-dimer tests. Hemostasis
disorder can affect several sepsis outcomes (mortality and duration of treatment period). This study aimed to determine the
correlation between hemostasis profile and sepsis outcome. This research was an analytical-observational with
retrospective cohort study design with subjects consisting of 76 sepsis patients at Dr. Mohammad Hoesin Hospital,
Palembang. The data were obtained by medical record observation and analyzed by Chi-Square and Spearman tests. From
76 sepsis patients, 76.7% of subjects had normal PT; 88.2% had normal aPTT; 71.1% had elevated fibrinogen, and 100% had
elevated D-dimer. The patients' sepsis outcomes showed that 67.1% survived, and 32.9% has died, and the duration of the
treatment period without much differences is as long as ≤ 12 days and > 12 days. The statistical analysis showed that there
was no significant relationship between PT, mortality, duration of the treatment period (p=1.000; p=0.418), between aPTT,
mortality, duration of the treatment period (p=0.709; p=0.480), between fibrinogen, mortality, duration of the treatment
period (p=0.350; p=1.000), and there was a weak negative correlation between D-dimer mortality and duration of the
treatment period (p=0.459; p=0.939). It could be concluded that there was no significant correlation between hemostasis
profile and sepsis outcome.


Keywords


Sepsis, prothrombin time, aPTT, fibrinogen, D-dimer

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References


Rello J, Valenzuela-Sánchez F, Ruiz-Rodriguez M,

Moyano S. Sepsis: A review of advances in

management. Advances in Therapy, 2017; 34(11):

-2411.

st 2. Daniels R, Nutbeam T. ABC of sepsis. 1 Ed., United

Kingdom, Wiley-Blackwell, 2010; 1.

Phua J, Ngerng WJ, See KC, Tay CK, Kiong T, et al.

Characteristics and outcomes of culture-negative

versus culture-positive severe sepsis, Critical Care

Medicine, 2013; 17: 1-20.

Smith EY, Charles LA, Cott EMV. Biphasic activated

partial thromboplastin time waveform and adverse

events in non–intensive care unit patients. American

Journal of Clinical Pathology, 2014; 121: 138–141.

Fenny, Dalimoenthe NZ, Noormartany, Pranggono E,

Dewi NS. Prothrombin time, activated partial

thromboplastin time, fibrinogen, dan D-dimer

sebagai prediktor decompensated disseminated

intravascular coagulation disseminated pada sepsis.

Majalah Kedokteran Bandung, 2014; 43(1): 49–54.

Szakmany T, Lundin RM, Sharif B, Ellis G, Morgan P,

Kopczynska M, Gunter U. Sepsis prevalence and

outcome on the general wards and emergency

departments in Wales: Results of a multi-center,

observational, point prevalence study. PLos One,

; 11(12): 1–12.

Melamed A, Sorvillo FJ. The burden of sepsisassociated

mortality in the United States from 1999 to

: An analysis of multiple-cause-of-death data.

Critical Care Medicine, 2009; 13 (R28).

Angele MK, Frantz MC, Chaudry IH. Gender and sex

hormones influence the response to trauma and

sepsis-potential therapeutic approaches, Clinics,

; 61(5): 479-488.

Angele MK, Pratschke S, Hubbard WJ, Claudry IH.

Gender differences in sepsis: Cardiovascular and

immunological aspects, Virulence 2014; 5(1): 12-19.

Tambajong RN, Lalenoh DC, Kumaat L. Profil penderita

sepsis di ICU RSUP Prof. Dr. R. D. Kandou Manado

periode Desember 2014-November 2015. Jurnal EClinic

; 4(1): 452–457.

Ahwini, Sastri Huya. Profil penderita sepsis di ICU

RSUP Haji Adam Malik Medan pada tahun 2016.

Medan, Universitas Sumatera Utara, 2017; 1.

Esper AM, Moss M, Lewis CA, Nisbet R, Mannino DM,

Martin GS. The role of infection and comorbidity:

Factors that influence disparities in sepsis. Critical Care

Medicine, 2006; 34(25): 76-82.

Kempker JA, Martin GS. The changing epidemiology

and definitions of sepsis. Clinics in chest medicine.

Philadelphia, Elsevier, 216; 37(2): 165-179.

Rahmawati E, Dalimoenthe NZ, Prihatni D.

Comparison between clot waveform analysis (CWA) of

normal and abnormal aPTT of sepsis patients in Dr.

Hasan Sadikin Hospital Bandung. Journal of Physics:

Conference Series, 2019; 1-10.

Iskander KN, Osuchowski MF, Stearns-Kurosawa DJ,

Kurosawa S, Stepien D, et al. Sepsis: Multiple

abnormalities, heterogeneous responses, and

evolving understanding. Physiological Reviews, 2013;

(3): 47-88.

Martin J, Wheeler A. Approach to the patient with

sepsis. Clinics in Chest Medicine, 2009; 30(1): 1–16.

Starr M, Saito H. Sepsis in old ages: Review of human

and animal studies. Aging and Disease, 2014; 5(2):

-136.

Lorente JA, Garcia-Frade LJ, Landin L, Pablo R, Torrado

C, et al. Time course of hemostatic abnormalities in

sepsis and its relation to outcome. Chest, 1993; 103:

-42.

Madsen T, Simmons J, Choo E, Portelli D, McGregor A,

et al. The DISPARITY study: Do gender differences

exist in the surviving sepsis campaign resuscitation bundle completion, completion of individual

elements, or sepsis mortality. Journal of Critical Care,

; 29(473): 7-11.

Davies GR, Pillai S, Lawrence M, Mills GM, Aubrey R,

et al. The effect of sepsis and inflammatory response

on mechanical clot characteristics: A prospective

observational study. Intensive Care Medicine, 2016;

(12): 1990–1998.

Williams MD, Braun LA, Cooper LM, Johnston J, Weiss

RV, et al. Hospitalized cancer patients with severe

sepsis: analysis of incidence, mortality, and associated

costs of care. Journal of Critical Care, 2014; 8: R291-298.




DOI: http://dx.doi.org/10.24293/ijcpml.v27i1.1658

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