[Investigation of hemostatic changes in patients with sepsis].
BACKGROUND
It is known that severe infection and inflammation lead to hemostatic abnormalities. Recently, much attention is focused on the mechanisms of infection or inflammation and on how it plays a central role in effecting the coagulation system. Disseminated intravascular coagulation in particular, is a common phenomenon in patients with sepsis, but the clinical implications of this condition are not clear. Therefore we attempted to evaluate the changes of the coagulation system in patients with sepsis and studied the factors that lead to such changes.


METHODS
One hundred one patients diagnosed with sepsis were enrolled in this study. The patients were clinically evaluated for underlying disease and data for inflammatory status and coagulative changes were evaluated retrospectively.


RESULTS
The WBC count increased in 76% and decreased in 6% of sepsis patients in comparison to the reference interval. The platelet count decreased in 65.3%. Changes in coagulative tests such as prothrombin time, activated partial thromboplastin time, antithrombin III, and D-dimer were observed in 70.4%, 52.7%, 87.2% and 100% of the patients, respectively. Correlation between ESR and fibrinogen was the highest in relation to the other coagulation factors. CRP also showed the highest correlation with fibrinogen in contrast to the other coagulation factors.


CONCLUSIONS
This study confirmed the clear activation of coagulation in patients with sepsis. Of the evaluated factors involved in coagulation and fibrinolysis, fibrinogen showed the highest correlation to indices representing the inflammatory state. However further studies on the anticoagulant pathway are necessary in elucidating this matter.
Kim
Gee-Young
GY
Department of Laboratory Medicine, Kyunghee University, College of Medicine, Seoul, Korea.
Park
Su-Yon
SY
Yoon
Hwi-Joong
HJ
Suh
Jin-Tae
JT
Kang
So-Young
SY
Lee
Woo-In
WI
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000175:diagnosis; D015415:Biomarkers / Q000032:analysis; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D002097:C-Reactive Protein / Q000032:analysis; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D013223:Statistics as Topic
D015415:Biomarkers; D002097:C-Reactive Protein