Coagulation tests on admission correlate with mortality and morbidity in general ICU patients: An observational study

Abstract

Background It is well known that low platelet count on admission to intensive care units (ICU) is associated with increased mortality. However, it is unknown whether prothrombin time (PT‐INR) and activated partial thromboplastin time (APTT) on admission correlate with mortality and organ failure. Therefore, the aim of this study was to investigate whether PT‐INR and APTT at admission can predict outcome in the critically ill patient after adjusting for severity of illness measured with Simplified Acute Physiology Score 3 (SAPS 3). Materials and Methods Data were retrospectively collected. APTT and PT‐INR taken on admission and SAPS 3 score were independent variables in all regression analyses. Survival analysis was done with Cox regression. Organ failure was reported as days alive and free (DAF) of vasopressors and invasive ventilation, need of continuous renal replacement therapy (CRRT) and Acute Kidney Injury Network creatinine score (AKIN‐crea). Results A total of 3585 ICU patients were included. Prolonged APTT correlated with mortality with 95% confidence interval (CI) of hazard ratio 1.001‐1.010. Prolonged APTT also correlated with DAF vasopressor, CRRT and AKIN‐crea with 95% CI of odds ratio (OR) 1.009‐1.034, 1.016‐1.037 and 1.009‐1.028, respectively. Increased PT‐INR correlated with DAF vasopressor and DAF ventilator with 95% CI of OR 1.112‐2.014 and 1.135‐1.847, respectively. Conclusions Activated partial thromboplastin time prolongation was associated with mortality and all morbidity outcomes except the DAF ventilator. PT‐INR increase at admission was associated with DAF vasopressor and DAF ventilator. APTT and PT‐INR at admission correlate with morbidity, which is not accounted for in the SAPS 3 model.

Long-term mortality predictors of ICU fungaemia

“…In this study, results show that age，INR and bilirubin are good predictors of short-term and long-term mortality of fungaemia. In particular, the INR is statistically significant in predicting 30-day [12,13]. One possible explanation we have found is the systemic inflammation that often occurs in patients with fungaemia and the interference between inflammatory pathways and the coagulation system.…”

“…Therefore, INR is a good predictor of mortality in fungaemia. In other reports, INR was associated with in-hospital mortality [ 12 , 13 ]. One possible explanation we have found is the systemic inflammation that often occurs in patients with fungaemia and the interference between inflammatory pathways and the coagulation system.…”

Prolonged activated partial thromboplastin time predicts poor short‐term prognosis in patients with acute pancreatitis: A retrospective cohort study

“… 12 Several studies have shown that prolonged APTT increases the risk of death in patients in the ICU with sepsis. 11 , 12 , 13 , 20 Sepsis is associated with increased APTT, and a prolonged APTT in patients with AP indicates the possibility of sepsis, and awareness should be raised to prevent and control infection in patients. Moreover, infection, sepsis, and infectious shock are common complications of AP.…”

“…In sepsis, prolonged APTT significantly impacted its severity and outcome 12 . Several studies have shown that prolonged APTT increases the risk of death in patients in the ICU with sepsis 11–13,20 . Sepsis is associated with increased APTT, and a prolonged APTT in patients with AP indicates the possibility of sepsis, and awareness should be raised to prevent and control infection in patients.…”

Vitamin K Effects on Gas6 and Soluble Axl Receptors in Intensive Care Patients: An Observational Screening Study

“…Many cancer and critically ill patients have nutritional, malabsorption, and metabolic defects with an increased risk for vitamin K deficiency [10,24,25]. Prolonged PT values on admission correlate with mortality and morbidity in general intensive care unit patients [42]. Could a more aggressive correction with vitamin K change the outcome?…”