Prospective study of coagulation parameters in septicemic patients

Abstract

Background and objectives. Sepsis is a critical clinical syndrome characterized by a systemic host response to infection, often leading to organ dysfunction and mortality. The association between early onset coagulopathy and mortality risk in septicemic patients remains an area of active investigation. This study aims to assess the association between early onset coagulopathy and increased mortality risk in septicemic patients. It also seeks to explore the role of procalcitonin (PCT) levels and demographic factors in the prognosis of septicemia. Material and methods. A cross-sectional study was conducted at Saveetha Medical College and Hospital, including 240 subjects who met the inclusion criteria. Patients were evaluated for the presence of coagulopathy (assessed by platelet count, INR, and aPTT values) and their PCT levels within 48 hours of admission. Data on demographic characteristics, underlying illnesses, and 28-day mortality were collected and analyzed. Results. The study population had a male preponderance (53.3%) with a mean age of 56.27 years. Diabetes mellitus was the most common underlying illness (32.5%). Coagulopathy was observed in 52.5% of patients, with thrombocytopenia and deranged INR and aPTT being significant indicators. Patients with life-threatening thrombocytopenia, severe PT-INR, and aPTT derangements showed high mortality rates (100%, 92.4%, and 90%-95.6% respectively). Mortality was significantly associated with coagulopathy and elevated PCT levels (>10.0 ng/ml), with 41.7% of subjects dying within 28 days of admission. Conclusions. Early onset coagulopathy is significantly associated with increased mortality in septicemic patients, highlighting the importance of coagulation parameters and PCT levels in predicting outcomes indicating prompt recognition and management of coagulopathy in septicemia, especially in younger patients and those with elevated PCT levels.