Hemostasis changes and its relationship with SOFA score in sepsis patients

Abstract

Introduction: Sepsis is a major health problem, and the incidence is still increasing. Generally, sepsis occurs in about 2% of all inpatients in developed countries. The immunologic response that causes sepsis is a systemic inflammatory response that causes activation of the inflammatory and coagulation pathways. If sepsis untreated, it can lead to organ failure then death. Organ dysfunction is expressed as an acute change of Sequential Organ Failure Assesment (SOFA) score >2 points as a consequence of infection.Methods: This is a cohort prospective’s study. Prothrombin time (PT), activated partial thromboplastin time (aPTT), Thrombin time (TT), Fibrinogen, D-dimer were examined 3 times (first, second, third day), and then assessed to see its relation with the corresponding SOFA score. Twenty-four subjects of the study were ICU patients in H. Adam Malik Hospital who matched the inclusion and exclusion criteria.Results: There were significant differences of PT on the first, second and third day (p =0.03). There were no significant differences in aPTT, TT, Fibrinogen, D-dimer on the first, second, third day. There were no significant correlations of PT, aPTT, TT, Fibrinogen with the corresponding SOFA score on the first, second, third day. There was a moderate positive correlation between D-dimer and SOFA score in the first, second and third day of examinations (p <0.05).Conclusion: PT changes occurred significantly on the first, second, third day of sepsis and D-dimers can be used to asses the risk of organ failure in septic patients.

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“…Factors that influence the quality of antibiotic use in sepsis patients in the ICU at Fatmawati Hospital are the type of antibiotic, the type of antibiotic therapy [33,34], the number of antibiotics, and the duration of antibiotic use [35]. Pharmacist recommendations can improve the quality of using antibiotics in the ICU ward of Fatmawati Hospital.…”