Hemostasis biomarkers and risk of sepsis: the REGARDS cohort. (23rd September 2016)

• Record Type: Journal Article
• Authors: Moore, J. X.; Zakai, N. A.; Mahalingam, M.; Griffin, R. L.; Irvin, M. R.; Safford, M. M.; Baddley, J. W.; Wang, H. E.
• Is Part Of: Journal of thrombosis and haemostasis. Volume 14:Number 11(2016:Nov.)
• Page Start: 2169
• Page End: 2176
• Publication Date: 2016-09-23
• Subjects: epidemiology -- factor IX -- factor VIII -- factor XI -- fibrinogen -- sepsis; Thrombosis -- Periodicals; Hemostasis -- Periodicals; Blood coagulation disorders -- Periodicals; 616.1
• DOI: 10.1111/jth.13446
• Languages: English
• ISSNs: 1538-7933

Abstract

Abstract : Essentials Few studies have investigated the risk of sepsis by baseline hemostasis biomarkers measures. Baseline hemostasis biomarkers and risk of sepsis was examined using case‐control study design. Increased fibrinogen, factor IX, and factor XI levels may be associated with risk of sepsis. Hemostasis biomarkers may provide a target for sepsis mitigation or prevention. Summary: Background: Sepsis is a major public health concern, responsible for more than 750 000 hospitalizations and 200 000 annual deaths in the USA. Few studies have investigated the association between baseline measurements of hemostasis biomarkers and the future risk of sepsis. Objective: To determine whether hemostasis biomarkers levels measured at baseline in a cohort of community‐dwelling participants are associated with the risk of future sepsis events. Methods: We performed a nested case–control study within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We identified sepsis hospitalizations occurring over a 10‐year period. There were 50 incident sepsis cases with baseline measurements of hemostasis (fibrinogen, factor VIII, FIX, FXI, protein C, and D‐dimer). Using incidence density sampling, we matched the 50 sepsis cases with 200 controls by age, sex, and race. We used conditional logistic regression to evaluate the association between baseline hemostasis biomarkers and future sepsis events. Results: Comparison of 50 sepsis cases with 200 non‐sepsis controls showed that sepsis cases had lower education and income, were more likely to live in the stroke belt, had chronic lung disease, and had higher albumin level/creatinine level ratios (ACRs). Individuals with higher baseline fibrinogen levels (adjusted odds ratio [OR] per standard deviation: 1.40, 95% confidence interval [CI] 1.01–1.94), FIX levels ([OR] 1.46, 95% [CI] 1.03–2.07) and FXI levels ([OR]1.52, 95% [CI] 1.04–2.23) were more likely to experience a sepsis event. Conclusion: Baseline fibrinogen, FIX and FXI levels are associated with future episodes of sepsis. Hemostasis biomarkers may provide targets for sepsis mitigation or prevention.