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Coagulative biomarkers on admission to the ICU predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection

PURPOSE: Sepsis-associated coagulopathy (SAC) contributes to the development of multiple organ failure (MOF) and increasing mortality. The present study was conducted to investigate whether coagulative biomarkers on admission to the intensive care unit (ICU) can predict acute kidney injury (AKI) and...

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Autores principales: Xu, Zhipeng, Cheng, Baoli, Fu, Shuiqiao, Liu, Xu, Xie, Guohao, Li, Zhongwang, Ji, Yun, Fu, Qinghui, Xu, Zhinan, Fang, Xiangming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732509/
https://www.ncbi.nlm.nih.gov/pubmed/31564926
http://dx.doi.org/10.2147/IDR.S218592
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author Xu, Zhipeng
Cheng, Baoli
Fu, Shuiqiao
Liu, Xu
Xie, Guohao
Li, Zhongwang
Ji, Yun
Fu, Qinghui
Xu, Zhinan
Fang, Xiangming
author_facet Xu, Zhipeng
Cheng, Baoli
Fu, Shuiqiao
Liu, Xu
Xie, Guohao
Li, Zhongwang
Ji, Yun
Fu, Qinghui
Xu, Zhinan
Fang, Xiangming
author_sort Xu, Zhipeng
collection PubMed
description PURPOSE: Sepsis-associated coagulopathy (SAC) contributes to the development of multiple organ failure (MOF) and increasing mortality. The present study was conducted to investigate whether coagulative biomarkers on admission to the intensive care unit (ICU) can predict acute kidney injury (AKI) and mortality in patients with septic shock caused by intra-abdominal infection (IAI). PATIENTS AND METHODS: An observational retrospective study was conducted in the surgical ICU. We studied patients who met the criteria of septic shock (Sepsis-3) caused by IAI between January 1, 2013, and December 31, 2016. By adjusting for baseline characteristics, multivariate regression analyses were employed to identify independent risk factors for predicting AKI and mortality. RESULTS: Of the 138 enrolled patients, 65 patients developed AKI. The patients who developed AKI exhibited a dramatically higher Sequential Organ Failure Assessment (SOFA) score (median, 12), Acute Physiology and Chronic Health Evaluation (APACHE) II score (median, 27.5) and mortality rate. In both models, we found that activated partial thromboplastin time (APTT) (odds ratio (OR)=1.074, 95% confidence interval (CI) 1.030–1.120, p=0.001), prothrombin time (PT) (OR=1.162, 95% CI 1.037–1.302, p=0.010) and D-dimer level (OR=1.098, 95% CI 1.002–1.202, p=0.045) on admission to the ICU were significant risk factors for AKI. Moreover, Cox regression analysis showed that prolonged APTT (OR=1.065, 95% CI 1.025–1.107, p=0.001) was independently associated with high mortality. CONCLUSION: In patients with septic shock caused by IAI, APTT, PT and D-dimer level on admission to the ICU were significantly associated with AKI. Furthermore, APTT was an independent predictor of 30-day mortality.
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spelling pubmed-67325092019-09-27 Coagulative biomarkers on admission to the ICU predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection Xu, Zhipeng Cheng, Baoli Fu, Shuiqiao Liu, Xu Xie, Guohao Li, Zhongwang Ji, Yun Fu, Qinghui Xu, Zhinan Fang, Xiangming Infect Drug Resist Original Research PURPOSE: Sepsis-associated coagulopathy (SAC) contributes to the development of multiple organ failure (MOF) and increasing mortality. The present study was conducted to investigate whether coagulative biomarkers on admission to the intensive care unit (ICU) can predict acute kidney injury (AKI) and mortality in patients with septic shock caused by intra-abdominal infection (IAI). PATIENTS AND METHODS: An observational retrospective study was conducted in the surgical ICU. We studied patients who met the criteria of septic shock (Sepsis-3) caused by IAI between January 1, 2013, and December 31, 2016. By adjusting for baseline characteristics, multivariate regression analyses were employed to identify independent risk factors for predicting AKI and mortality. RESULTS: Of the 138 enrolled patients, 65 patients developed AKI. The patients who developed AKI exhibited a dramatically higher Sequential Organ Failure Assessment (SOFA) score (median, 12), Acute Physiology and Chronic Health Evaluation (APACHE) II score (median, 27.5) and mortality rate. In both models, we found that activated partial thromboplastin time (APTT) (odds ratio (OR)=1.074, 95% confidence interval (CI) 1.030–1.120, p=0.001), prothrombin time (PT) (OR=1.162, 95% CI 1.037–1.302, p=0.010) and D-dimer level (OR=1.098, 95% CI 1.002–1.202, p=0.045) on admission to the ICU were significant risk factors for AKI. Moreover, Cox regression analysis showed that prolonged APTT (OR=1.065, 95% CI 1.025–1.107, p=0.001) was independently associated with high mortality. CONCLUSION: In patients with septic shock caused by IAI, APTT, PT and D-dimer level on admission to the ICU were significantly associated with AKI. Furthermore, APTT was an independent predictor of 30-day mortality. Dove 2019-09-04 /pmc/articles/PMC6732509/ /pubmed/31564926 http://dx.doi.org/10.2147/IDR.S218592 Text en © 2019 Xu et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Xu, Zhipeng
Cheng, Baoli
Fu, Shuiqiao
Liu, Xu
Xie, Guohao
Li, Zhongwang
Ji, Yun
Fu, Qinghui
Xu, Zhinan
Fang, Xiangming
Coagulative biomarkers on admission to the ICU predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection
title Coagulative biomarkers on admission to the ICU predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection
title_full Coagulative biomarkers on admission to the ICU predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection
title_fullStr Coagulative biomarkers on admission to the ICU predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection
title_full_unstemmed Coagulative biomarkers on admission to the ICU predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection
title_short Coagulative biomarkers on admission to the ICU predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection
title_sort coagulative biomarkers on admission to the icu predict acute kidney injury and mortality in patients with septic shock caused by intra-abdominal infection
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732509/
https://www.ncbi.nlm.nih.gov/pubmed/31564926
http://dx.doi.org/10.2147/IDR.S218592
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