Journal of critical care · 2026
The impact of coagulopathy on prognosis in critically ill patients with sepsis: A nationwide cohort study.
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Ha Heonyeong, Hyun Dong-Gon, Ahn Jee Hwan, Huh Jin Won, Hong Sang-Bum, Koh Younsuck, Oh Dong Kyu, Lee Su Yeon, Park Mi Hyeon, Lim Chae-Man, Korean Sepsis Alliance (KSA) Investigators
Аннотация
INTRODUCTION: Coagulation impairment is frequently observed in patients with sepsis. However, the relationship between coagulopathy and outcomes in Korean sepsis patients remains poorly defined.
METHODS: We analyzed a nationwide cohort of 13,827 sepsis patients from 15 hospitals in South Korea between September 2019 and December 2022. Patients were classified into three groups according to sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scores: SIC (-), SIC (+), and DIC (+). The primary outcome was 28-day mortality; the secondary outcome was the incidence of major bleeding events.
RESULTS: Among 3217 patients, 1696 (52.7%) were in the SIC (-) group, 932 (29.0%) in the SIC (+) group, and 589 (18.3%) in the DIC (+) group. After adjustment for covariates, both the SIC (+) group (adjusted hazard ratio [aHR] 1.35, 95% confidence interval [CI] 1.16-1.58, p < 0.001) and the DIC (+) group (aHR 1.59, 95% CI 1.33-1.90, p < 0.001) showed significantly increased 28-day mortality. Major bleeding events, although infrequent across all groups, increased in the DIC (+) group (adjusted odds ratio [aOR] 2.02, 95% CI 1.03-3.88, p = 0.036); however, no significant increase was observed in the SIC (+) group (aOR 1.20, 95% CI 0.60-2.33, p = 0.600) compared with the SIC (-) group.
CONCLUSIONS: In this nationwide cohort, sepsis-induced coagulopathy was associated with higher 28-day mortality but not with a significantly increased risk of major bleeding.
METHODS: We analyzed a nationwide cohort of 13,827 sepsis patients from 15 hospitals in South Korea between September 2019 and December 2022. Patients were classified into three groups according to sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC) scores: SIC (-), SIC (+), and DIC (+). The primary outcome was 28-day mortality; the secondary outcome was the incidence of major bleeding events.
RESULTS: Among 3217 patients, 1696 (52.7%) were in the SIC (-) group, 932 (29.0%) in the SIC (+) group, and 589 (18.3%) in the DIC (+) group. After adjustment for covariates, both the SIC (+) group (adjusted hazard ratio [aHR] 1.35, 95% confidence interval [CI] 1.16-1.58, p < 0.001) and the DIC (+) group (aHR 1.59, 95% CI 1.33-1.90, p < 0.001) showed significantly increased 28-day mortality. Major bleeding events, although infrequent across all groups, increased in the DIC (+) group (adjusted odds ratio [aOR] 2.02, 95% CI 1.03-3.88, p = 0.036); however, no significant increase was observed in the SIC (+) group (aOR 1.20, 95% CI 0.60-2.33, p = 0.600) compared with the SIC (-) group.
CONCLUSIONS: In this nationwide cohort, sepsis-induced coagulopathy was associated with higher 28-day mortality but not with a significantly increased risk of major bleeding.