Abstract
SESSION TITLE: Critical Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Septicemia is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. Disseminated Intravascular Coagulation (DIC) is a severe complication of sepsis associated with increased mortality and morbidity. We aim to analyze the trends and predictors of DIC in septicemia from a large national database to estimate current epidemiology and modifiable or non-modifiable risk predictors. METHODS: Study cohort is derived from the Nationwide Inpatient Sample (NIS) for the years 2008-2017. Adult Hospitalizations due to septicemia were identified using International Classification of Diseases (9th/10th Editions) Clinical Modification Procedural codes (ICD-9-CM/ICD-10-CM) procedures codes. We excluded patients with pregnancy related diagnoses. DIC and other diagnosis of interests were identified by ICD-9/10-CM diagnosis codes and Elixhauser comorbidity software. We then utilized the Cochran Armitage trend test and multivariate survey logistic regression models to analyze temporal incidence trends, and predictors. RESULTS: Out of a total 12,820,000 hospitalizations who had septicemia, 153,181(1.18%) was complicated by DIC. Proportion of DIC decreased from 1.6% in 2008 to 0.8% in 2017 with 6% decrease (OR 0.94; 95%CI 0.93-0.94; p<0.001) over the study years. Patients who developed DIC had lower mean age (63 vs 67; p<0.001) and were more likely to be females (53% vs 47%, p<0.001). In multivariable regression analysis, predictors of increased DIC are female sex (OR 1.20; 95%CI 1.17-1.23; p<0.0001), Asian/Other races (OR 1.08; 95%CI 1.02-1.11; p=0.008) and Uninsured/Self Pay (OR 1.19; 95%CI 1.13-1.25; p<0.001). Also, patients with concurrent diagnoses such as Pulmonary circulatory diseases (OR 1.23; 95%CI 1.16-1.29; p<0.001), Congestive Heart Failure, Hypertension, Diabetes Mellitus, Renal Failure, Liver Failure, Obesity and Anemia were at the increased odds of developing DIC. CONCLUSIONS: We observed that incidence of DIC in septicemia hospitalizations has decreased over the last decade. Multiple risk factors association have been identified with the development of DIC in septicemia, some of which are potentially modifiable. CLINICAL IMPLICATIONS: Our study advocates the need for early diagnosis and better risk stratification of patients with Septicemia who develop DIC during hospitalization. Further in-depth studies are warranted to understand the causality of some of the potentially modifiable risk factors which were identified in our study. Over the long term, this may help mitigate the incidence of DIC in septicemia hospitalizations even further. DISCLOSURES: No relevant relationships by Vaghdevi Bagam, source=Web Response No relevant relationships by Pawandeep Kaur, source=Web Response No relevant relationships by Hira Khan, source=Web Response No relevant relationships by Faizan Malik, source=Web Response No relevant relationships by Uvesh Mansuri, source=Web Response No relevant relationships by Safala Maskey, source=Web Response No relevant relationships by Achint Patel, source=Web Response No relevant relationships by Harshil Shah, source=Web Response No relevant relationships by jasvinder singh, source=Web Response No relevant relationships by Shreenivas Ashok Sreenivasan, source=Web Response
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