Table of Contents
ISRN Critical Care
Volume 2013, Article ID 219048, 6 pages
http://dx.doi.org/10.5402/2013/219048
Research Article

Predictors of Disseminated Intravascular Coagulation in Patients with Septic Shock

1Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
2Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Rochester, MN 55905, USA
3Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA

Received 6 August 2013; Accepted 2 September 2013

Academic Editors: M. S. C. de Assuncao and N. Gibney

Copyright © 2013 Diana J. Kelm et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. The goal of this study was to identify potential clinical predictors for the development of disseminated intravascular coagulation (DIC) in patients with septic shock. Material and Methods. We performed a retrospective analysis of a cohort of adult (>18 years of age) patients with septic shock admitted to a medical ICU in a tertiary care hospital from July 2005 until September 2007. A multivariate logistic regression model was used to determine the association of risk factors with overt DIC. Results. In this study, a total of 390 patients with septic shock were analyzed, of whom 66 (17%) developed overt DIC. Hospital mortality was significantly greater in patients who developed overt DIC (68% versus 38%, ). A delay in the timing of antibiotics was associated with an increased risk of the development of overt DIC ( ). Patients on antiplatelet therapy prior to hospital admission and who that received adequate early goal-directed therapy (EGDT) were associated with a decreased risk of overt DIC ( ). Conclusions. In our cohort of patients with septic shock, there was a risk reduction for overt DIC in patients on antiplatelet therapy and adequate EGDT, while there was an increased risk of DIC with antibiotic delay.