The diagnostic role of C2PAC index in cases of sepsis-induced coagulopathy (SIC)

Abstract Background To study the potential role of the C2PAC index (a ratio of soluble type C lectin-like receptor 2 level sCLEC-2 and platelet count) in sepsis-induced coagulopathy with the possibility of using this index as an early predictor in sepsis and sepsis-induced coagulopathy. Methods Our case–control study included a total of 86 participants divided into 2 groups: group I is the case group consisting of 56 patients of sepsis or septic shock and group II (control group) of 30 healthy persons: sex and age-matched healthy individuals. All patients were subjected to assessment of C lectin domain family 2 receptor (sCLEC2), by enzyme-linked immunosorbent assay ELIZA kit, then C2PAC index (a ratio of soluble type C lectin-like receptor 2 level sCLEC-2 and platelet count) was calculated using the platelet count. Results Our study demonstrated that sCLEC-2 levels and C2PAC in group I were higher than in group II ( p value < 0.001), and Klebsiella was the most common organism detected in ICU septic patients; detected in 25 patients (44.6%), there is a statistical significance ( p value 0.045) between sCLEC2 levels and streptococcal infections. It was detected also that the SIC group was 17 patients (30.4%) and the sepsis without coagulopathy group was 39 patients (69.6%). Compared with the sepsis without coagulopathy group, the SIC group was significantly older and had a significantly higher SOFA score, sCLEC-2 levels, and C2PAC index. Lastly, the strong potentiality of using C2PAC as a diagnostic and prognostic marker for sepsis-induced coagulopathy with high statistical significance < 0. 001. Conclusions C2PAC index can be validated as an accurate marker of sepsis-induced coagulopathy with higher sensitivity when using the C2PAC index (82.4%) than using sCLEC-2 (58.8%) and both have the same specificity (89.7%). The C2PAC index is a useful predictor of SIC progression.