avicenna medical research
Volume 4, Numéro 4, Pages 160-166
2025-12-31

Hemostatic Alterations And Sepsis-induced Coagulopathy: Epidemiology, Complications, And Mortality Risk Factors



Authors : Khiar S . Taleb A .

Abstract

Abstract Background: Sepsis is associated with significant alterations in coagulation, often leading to disseminated intravascular coagulation (DIC) and increased mortality. This study aimed to evaluate hemostatic changes, the occurrence of DIC, hemorrhagic and thrombo-ischemic complications, and factors influencing mortality in septic patients. Methods: A prospective observational study was conducted on septic patients admitted to the intensive care unit. Hemostatic parameters including platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimers were measured. DIC was assessed using ISTH, JAAM, and SIC scores. Complications and mortality were recorded, and statistical analyses were performed to identify associated risk factors. Results: Hemostatic alterations were observed in nearly 95% of patients. Thrombocytopenia (<150,000/µL) was present in 37%, with a mean platelet count of 195,232 ± 114,298/µL. PT and aPTT were abnormal in 34% and 27% of cases, respectively. D-dimers were elevated in 95% of patients, while fibrinogen was high in 76% of cases. DIC occurred in 21% of patients by ISTH, 35% by JAAM, and 45% by SIC criteria. Hemorrhagic complications were observed in 8.5% of patients, and thrombo-ischemic events in 13%. Higher ISTH, JAAM, and SIC scores at admission were significantly associated with increased mortality, with odds ratios of 1.62, 1.47, and 1.43, respectively. Conclusion: Hemostatic disturbances are common in sepsis, with a significant proportion developing DIC. Complications, both hemorrhagic and thrombo-ischemic, contribute to mortality. Early recognition using scoring systems such as ISTH, JAAM, and SIC can help identify high-risk patients and guide management strategies.

Keywords

Sepsis, Coagulopathy, DIC, Hemorrhage, Thrombosis, Mortality

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