Infection site modifies the prognostic impact of disseminated intravascular coagulation in sepsis

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2026-07-01 Epub Date: 2026-06-23 DOI:10.1016/j.thromres.2026.109761

Wataru Takayama, Natsuko Tomita, Yuhi Matsuo, Koji Morishita

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引用次数: 0

Abstract

Background

Disseminated intravascular coagulation (DIC) is a common, life-threatening sepsis complication. Although DIC severity is widely used for risk stratification, whether its prognostic impact varies by infection site remains unclear.

Methods

We conducted a retrospective cohort study of adults with sepsis admitted to a tertiary critical care center between 2015 and 2025. DIC was defined as a Japanese Association for Acute Medicine score of ≥4 on hospital days 1–3. Patients were grouped by infection site. The primary outcome was in-hospital mortality, and secondary outcomes were ventilator-free days (VFD) and intensive care unit-free days (IFD). Multivariable regression models adjusted for age and sex were used to evaluate the association between DIC and outcomes, including interaction analysis by infection site.

Results

Among 933 patients, 568 (60.9%) developed DIC. DIC was associated with higher mortality and fewer VFD and IFD, with the strongest mortality association in pulmonary (aOR 4.5, 95% confidence interval [CI] 2.2–8.3) and urinary tract infections (aOR 3.2, 95% CI 1.4–9.4) (P for interaction = 0.02). DIC most commonly became apparent on hospital day 2.

Conclusions

The prognostic impact of DIC in sepsis varies by infection site. Sepsis-associated DIC may not represent a uniform entity across infection phenotypes. Further studies are needed to clarify site-specific risks and mechanisms to optimize treatment strategies.

查看原文本刊更多论文

感染部位改变脓毒症患者弥散性血管内凝血对预后的影响。

背景：弥散性血管内凝血（DIC）是一种常见的危及生命的脓毒症并发症。尽管DIC严重程度被广泛用于风险分层，但其预后影响是否因感染部位而异仍不清楚。方法：我们对2015年至2025年间入住三级重症监护中心的成人败血症患者进行了回顾性队列研究。DIC定义为住院第1-3天日本急性医学协会评分≥4分。按感染部位分组。主要终点是住院死亡率，次要终点是无呼吸机天数（VFD）和无重症监护病房天数（IFD）。采用调整年龄和性别的多变量回归模型来评估DIC与预后之间的关系，包括感染部位的相互作用分析。结果：933例患者中，568例（60.9%）发生DIC。DIC与较高的死亡率、较低的VFD和IFD相关，其中肺部感染（aOR为4.5,95%可信区间[CI] 2.2-8.3）和尿路感染（aOR为3.2,95% CI为1.4-9.4）的死亡率相关性最强（相互作用P = 0.02）。DIC最常见于住院第2天。结论：DIC对脓毒症的预后影响因感染部位而异。脓毒症相关DIC可能不代表感染表型的统一实体。需要进一步的研究来明确特定部位的风险和机制，以优化治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.