Sepsis-associated coagulopathy in onco-hematology patients presenting with thrombocytopenia: a multicentric observational study. Issue 1 (2nd January 2023)

• Record Type: Journal Article
• Authors: Lemiale, Virginie; Mabrouki, Asma; Miry, Loïc; Mokart, Djamel; Pène, Frédéric; Kouatchet, Achille; Mayaux, Julien; Bruneel, Fabrice; Perez, Pierre; Meert, Anne-Pascale; Moreau, Anne-Sophie; Benoit, Dominique; Darmon, Michael; Zafrani, Lara; Clere-Jehl, Raphaël
• Is Part Of: Leukemia & lymphoma. Volume 64:Issue 1(2023)
• Page Start: 197
• Page End: 204
• Publication Date: 2023-01-02
• Subjects: (MeSH terms): sepsis -- disseminated intravascular coagulation -- intensive care unit -- hematologic neoplasms -- thrombocytopenia; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2022.2136971
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Coagulation disorders increase mortality rate during septic shock, but the impact of concomitant hematological malignancies remains unknown. The study assessed coagulation disorders in onco-hematological patients with thrombocytopenia (<100 G/L) admitted to ICU for septic shock. Among 146 included patients, 50 patients had lymphoma and 49 patients had acute leukemia. ICU mortality rate was 43.8% ( n = 64). Median increase in prothrombin time (PT) at day(d) 1 was 4.7 s (IQR 3.2–7.9) in ICU survivors vs. 6.4 s (IQR 4.5–13.7; p < 0.01 ) in non-survivors. Fibrinogen kinetics (increase in fibrinogen levels between d1 and d2) was +0.55 (−0.22–1.55) vs. +0.10 g/L (−0.40–0.50; p = 0.03 ) in surviving and non-surviving patients, respectively. PT increase ≥6 s at d1 (OR 5.5; 95% CI 1.1–6.0; p = 0.03 ) and mechanical ventilation (OR 7.4; 95% CI 3.3–17.7; p < 0.001 ) were independently associated with ICU mortality. This study provides information and new ways to identify hematological patients with high-risk mortality.