scholarly journals The protective association of endogenous immunoglobulins against sepsis mortality is restricted to patients with moderate organ failure

2017 ◽  
Author(s):  
Ignacio Martin-Loeches ◽  
Arturo Muriel-Bombín ◽  
Ricard Ferrer ◽  
Antonio Artigas ◽  
Jordi Sole-Violan ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Organ Failure ◽  
Mortality Risk ◽  
Multivariate Logistic Regression Analysis ◽  
Predictive Ability ◽  
Simultaneous Presence ◽  
Icu Mortality ◽  
Icu Admission ◽  
The Impact ◽  
Immunoglobulin Levels

AbstractBackgroundpre-evaluation of endogenous immunoglobulin levels is a potential strategy to improve the results of intravenous immunoglobulins in sepsis, but more work has to be done to identify those patients who could benefit the most from this treatment. The objective of this study was to evaluate the impact of endogenous immunoglobulins on the mortality risk in sepsis depending on disease severity.Methodsthis was a retrospective observational study including 278 patients admitted to the ICU with sepsis fulfilling the SEPSIS-3 criteria, coming from the Spanish GRECIA and ABISS-EDUSEPSIS cohorts. Patients were distributed into two groups depending on their Sequential Organ Failure Assessment score al ICU admission (SOFA < 8, n = 122 and SOFA ≥ 8, n = 156) and the association between immunoglobulin levels at ICU admission with mortality was studied in each group by Kaplan Meier and multivariate logistic regression analysis.ResultsICU / hospital mortality in the SOFA < 8 group was 14.8% / 23.0%, compared to 30.1 % / 35.3% in the SOFA ≥ 8 group. In the group with SOFA < 8, the simultaneous presence of total IgG <407 mg/dl, IgM < 43 mg/dl and IgA < 219 mg/dl was associated to a reduction in the survival mean time of 6.6 days in the first 28 days, and was a robust predictor of mortality risk either during the acute and the post-acute phase of the disease (OR for ICU mortality: 13.79; OR for hospital mortality: 7.98). This predictive ability remained in the absence of prior immunosupression (OR for ICU mortality: 17.53; OR for hospital mortality: 5.63). Total IgG <407 mg/dl or IgG1 < 332 mg/dl was also an independent predictor of ICU mortality in this group. In contrast, in the SOFA ≥ 8 group, we found no immunoglobulin thresholds associated to neither ICU nor to hospital mortality.Conclusionsendogenous immunoglobulin levels may have a different impact on the mortality risk of sepsis patients based on their severity. In patients with moderate organ failure, the simultaneous presence of low levels of IgG, IgA and IgM was a consistent predictor of both acute and post-acute mortality.

scholarly journals Predicting severe outcomes using national early warning score (NEWS) in patients identified by a rapid response system: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sang Hyuk Kim ◽  
Hye Suk Choi ◽  
Eun Suk Jin ◽  
Hayoung Choi ◽  
Hyun Lee ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Retrospective Cohort ◽  
Predictive Ability ◽  
Early Warning Score ◽  
Rapid Response System ◽  
Icu Mortality ◽  
Icu Admission ◽  
Response System ◽  
National Early Warning Score

AbstractThere are insufficient data in managing patients at high risk of deterioration. We aimed to investigate that national early warning score (NEWS) could predict severe outcomes in patients identified by a rapid response system (RRS), focusing on the patient’s age. We conducted a retrospective cohort study from June 2019 to December 2020. Outcomes were unplanned intensive care unit (ICU) admission, ICU mortality, and in-hospital mortality. We analyzed the predictive ability of NEWS using receiver operating characteristics (ROC) curve and the effect of NEWS parameters using multivariable logistic regression. A total of 2,814 RRS activations were obtained. The predictive ability of NEWS for unplanned ICU admission and in-hospital mortality was fair but was poor for ICU mortality. The predictive ability of NEWS showed no differences between patients aged 80 years or older and under 80 years. However, body temperature affected in-hospital mortality for patients aged 80 years or older, and the inverse effect on unplanned ICU admission was observed. The NEWS showed fair predictive ability for unplanned ICU admission and in-hospital mortality among patients identified by the RRS. The different presentations of patients 80 years or older should be considered in implementing the RRS.

scholarly journals The association between the quick sequential organ failure assessment score prior to emergency ICU admission and outcomes in adults with suspected infection

2020 ◽  
pp. 149-154
Author(s):  
S Pillay ◽  
T Kisten ◽  
HM Cassimjee
Keyword(s):  
Hospital Mortality ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Icu Mortality ◽  
Suspected Infection ◽  
Icu Admission ◽  
Icu Stay ◽  
Failure Assessment ◽  
Qsofa Score ◽  
Length Of Icu Stay

Background: Sepsis and septic shock are leading causes of mortality world-wide. In patients outside the intensive care unit (ICU) a rising qSOFA (quick Sequential Organ Failure Assessment) score correlates with mortality risk. We sought to investigate if the duration of a qSOFA score ≥ 2 prior to ICU admission further affects outcomes, namely: ICU mortality, in-hospital mortality and length of ICU stay. Method: A retrospective chart review was performed using the electronic ICU database at a quaternary level hospital in Durban, KwaZulu-Natal, examining entries from 1 January 2008 to 31 December 2017. The review included 235 emergency in-hospital adult admissions with suspected infection, of which 144 had a qSOFA score ≥ 2 prior to ICU admission. Results: There was no significant association between the duration of a qSOFA score ≥ 2 prior to ICU admission and ICU mortality (p = 0.975), in-hospital mortality (p = 0.918) and length of ICU stay until demise (p = 0.848) or discharge (p = 0.624). The qSOFA score was significantly associated with ICU mortality with scores of 0, 1, 2 and 3 resulting in ICU mortality rates of 0%, 22.5%, 53.7% and 84.6% respectively (p < 0.001). Conclusion: The duration of a qSOFA score ≥ 2 prior to emergency ICU admission was not significantly associated with ICU mortality, in-hospital mortality or length of ICU stay in adults with suspected infection.

scholarly journals LO52: Classification versus prediction of mortality using the Systemic Inflammatory Response score and quick Sepsis-related Organ Failure Assessment scores in patients with infection

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S26
Author(s):  
D. Lane ◽  
S. Lin ◽  
D. Scales
Keyword(s):  
Decision Making ◽  
Inflammatory Response ◽  
Hospital Mortality ◽  
Organ Failure ◽  
Mortality Risk ◽  
Classification Accuracy ◽  
Predictive Ability ◽  
C Statistic ◽  
Failure Assessment ◽  
Qsofa Score

Introduction: Despite their widespread use, measures of classification accuracy (i.e. sensitivity and specificity) have several limitations that conceals relevant information and may bias decision-making. Assessing the predictive ability of clinical tools instead may provide more useful prognostic information to support decision-making, particularly in an Emergency setting. We sought to contrast classification accuracy versus predictive ability of the Systemic Inflammatory Response Syndrome (SIRS) and quick Sepsis-related Organ Failure Assessment (qSOFA) Sepsis scores for determining mortality risk among patients with infection transported by paramedics. Methods: A one-year cohort of patients with infections transported to the Emergency Department by paramedics was linked to in-hospital administrative databases. Hospital mortality was determined for each patient at the time of discharge. We calculated sensitivity and specificity of SIRS and qSOFA for classifying hospital mortality across different score thresholds, and estimated discrimination (assessed using the C statistic) and calibration (assessed visually) of prediction. Prediction models for hospital mortality were constructed using the aggregated SIRS or qSOFA scores for each patient as a predictor, while accounting for clustering by institution and adjusting for differences in patient age and sex. Predicted and observed risk were plotted to assess calibration and change in risk across levels of each score. Results: A total of 10,409 patients with infection who were transported by paramedics were successfully linked, with an overall mortality rate of 9.2%. The median SIRS score among non-survivors was 2, while the median qSOFA score was 1. SIRS score had higher sensitivity estimates than qSOFA for classifying hospital mortality at all thresholds (0.11 – 0.83 vs. 0.08 – 0.80), but the qSOFA score had better discrimination (C statistic 0.76 vs. 0.71) and calibration. The risk of hospital mortality predicted by the SIRS score ranged from 6.6-24% across score values, whereas the risk predicted by the qSOFA score ranged from 8.6-53%. Conclusion: Assessing the SIRS and qSOFA scores predictive ability reveals that the qSOFA score provides more information to clinicians about a patient's mortality risk despite having worse sensitivity. This study highlights important limitations of classification accuracy for diagnostic test studies and supports a shift toward assessing predictive ability instead. Character count 2490

scholarly journals P082: Predictive ability of the quick Sepsis-related Organ Failure Assessment score among patients with infection transported by paramedics: a Bayesian analysis

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S93
Author(s):  
S. Alex Love ◽  
D. Lane
Keyword(s):  
Glasgow Coma Scale ◽  
Hospital Mortality ◽  
Bayesian Analysis ◽  
Organ Failure ◽  
Predictive Ability ◽  
Decision Threshold ◽  
Coma Scale ◽  
C Statistic ◽  
Failure Assessment ◽  
Qsofa Score

Introduction: The quick Sepsis-related Organ Failure Assessment (qSOFA) score was developed to provide clinicians with a quick assessment for patients with latent organ failure possibly consistent with sepsis at high-risk for mortality. With the clinical heterogeneity of patients presenting with sepsis, a Bayesian validation approach may provide a better understanding of its clinical utility. This study used a Bayesian analysis to assess the prediction of hospital mortality by the qSOFA score among patients with infection transported by paramedics. Methods: A one-year cohort of adult patients transported by paramedics in a large, provincial EMS system was linked to Emergency Department (ED) and hospital administrative databases, then restricted to those patients with an ED diagnosed infection. A Bayesian binomial regression model was constructed using Hamiltonian Markov-Chain Monte-Carlo sampling, normal priors for each parameter, the calculated score, age and sex as the predictors, and hospital mortality as the outcome. Discrimination was assessed using posterior predictions to calculate a “Bayesian” C statistic, and calibration was assessed with calibration plots of the observed and predicted probability distributions. The independent predictive ability of each measure was tested by including each component measure (respiratory rate, Glasgow Coma Scale, and systolic blood pressure) as continuous predictors in a second model. Results: A total of 9,920 patients with ED diagnosed infection were included. 264 (2.7%) patients were admitted directly to the ICU, and 955 (9.6%) patients died in-hospital. As independent predictors, the probability of mortality increased as each measure became more extreme, with the Glasgow Coma Scale predicting the greatest change in mortality risk from a high to low score; however, no dramatic change in the probability supporting a single decision threshold was seen for any measure. For the calculated score, the C statistic for predicting mortality was 0.728. The calibration curve had no overlap of predictions, with a probability of 0.5 (50% credible interval 0.47-0.53) for patients with a qSOFA score of 3. Conclusion: Although no single decision threshold was identified for each component measure, a calculated qSOFA score provides good prediction of mortality for patients with ED diagnosed infection. When validating clinical prediction scores, a Bayesian approach may be used to assess probabilities of interest for clinicians to support better clinical decision making. Character count 2494

scholarly journals Sequential Organ Failure Assessment Component Score Prediction of In-hospital Mortality From Sepsis

2018 ◽  
Vol 35 (8) ◽  
pp. 810-817 ◽  
Author(s):  
Tushar Gupta ◽  
Michael A. Puskarich ◽  
Elizabeth DeVos ◽  
Adnan Javed ◽  
Carmen Smotherman ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Sofa Score ◽  
Statistical Significance ◽  
Predictive Ability ◽  
Hospital Death ◽  
Icu Stay ◽  
Relative Contribution ◽  
Failure Assessment

Objectives: Early organ dysfunction in sepsis confers a high risk of in-hospital mortality, but the relative contribution of specific types of organ failure to overall mortality is unclear. The objective of this study was to assess the predictive ability of individual types of organ failure to in-hospital mortality or prolonged intensive care. Methods: Retrospective cohort study of adult emergency department patients with sepsis from October 1, 2013, to November 10, 2015. Multivariable regression was used to assess the odds ratios of individual organ failure types for the outcomes of in-hospital death (primary) and in-hospital death or ICU stay ≥ 3 days (secondary). Results: Of 2796 patients, 283 (10%) experienced in-hospital mortality, and 748 (27%) experienced in-hospital mortality or an ICU stay ≥ 3 days. The following components of Sequential Organ Failure Assessment (SOFA) score were most predictive of in-hospital mortality (descending order): coagulation (odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.32-1.93), hepatic (1.58, 95% CI: 1.32-1.90), respiratory (OR: 1.33, 95% CI: 1.21-1.47), neurologic (OR: 1.20, 95% CI: 1.07-1.35), renal (OR: 1.14, 95% CI: 1.02-1.27), and cardiovascular (OR: 1.13, 95% CI: 1.01-1.25). For mortality or ICU stay ≥3 days, the most predictive SOFA components were respiratory (OR: 1.97, 95% CI: 1.79-2.16), neurologic (OR: 1.72, 95% CI: 1.54-1.92), cardiovascular (OR: 1.38, 95% CI: 1.23-1.54), coagulation (OR: 1.31, 95% CI: 1.10-1.55), and renal (OR: 1.19, 95% CI: 1.08-1.30) while hepatic SOFA (OR: 1.16, 95% CI: 0.98-1.37) did not reach statistical significance ( P = .092). Conclusion: In this retrospective study, SOFA score components demonstrated varying predictive abilities for mortality in sepsis. Elevated coagulation or hepatic SOFA scores were most predictive of in-hospital death, while an elevated respiratory SOFA was most predictive of death or ICU stay >3 days.

scholarly journals Impact of cardiovascular disease and cardiac injury on in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis

Heart ◽  
2020 ◽  
Vol 106 (15) ◽  
pp. 1142-1147 ◽  
Author(s):  
Xintao Li ◽  
Bo Guan ◽  
Tong Su ◽  
Wei Liu ◽  
Mengyao Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Hospital Mortality ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Cardiac Injury ◽  
Sensitivity Analyses ◽  
Future Research ◽  
Cardiovascular Comorbidities ◽  
The Impact

BackgroundCoronavirus disease 2019 (COVID-19) has produced a significant health burden worldwide, especially in patients with cardiovascular comorbidities. The aim of this systematic review and meta-analysis was to assess the impact of underlying cardiovascular comorbidities and acute cardiac injury on in-hospital mortality risk.MethodsPubMed, Embase and Web of Science were searched for publications that reported the relationship of underlying cardiovascular disease (CVD), hypertension and myocardial injury with in-hospital fatal outcomes in patients with COVID-19. The ORs were extracted and pooled. Subgroup and sensitivity analyses were performed to explore the potential sources of heterogeneity.ResultsA total of 10 studies were enrolled in this meta-analysis, including eight studies for CVD, seven for hypertension and eight for acute cardiac injury. The presence of CVD and hypertension was associated with higher odds of in-hospital mortality (unadjusted OR 4.85, 95% CI 3.07 to 7.70; I2=29%; unadjusted OR 3.67, 95% CI 2.31 to 5.83; I2=57%, respectively). Acute cardiac injury was also associated with a higher unadjusted odds of 21.15 (95% CI 10.19 to 43.94; I2=71%).ConclusionCOVID-19 patients with underlying cardiovascular comorbidities, including CVD and hypertension, may face a greater risk of fatal outcomes. Acute cardiac injury may act as a marker of mortality risk. Given the unadjusted results of our meta-analysis, future research are warranted.

scholarly journals Impact of non-cystic fibrosis bronchiectasis on critically ill patients in Korea: a retrospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Youngmok Park ◽  
Seung Hyun Yong ◽  
Ah Young Leem ◽  
Song Yee Kim ◽  
Sang Hoon Lee ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Odds Ratio ◽  
Negative Impact ◽  
Icu Mortality ◽  
Chest Computed Tomography ◽  
Lower Survival Rate ◽  
All Cause Mortality ◽  
Hospital Stays ◽  
The Mean ◽  
The Impact

AbstractThis study investigated the impact of bronchiectasis on patients admitted to the intensive care unit (ICU) at a hospital in Korea. Patients with bronchiectasis were diagnosed using results of chest computed tomography performed before ICU admission. The severity of bronchiectasis was based on the number of affected lobes, and patients with ≥ 3 bronchiectatic lobes were classified into the severe bronchiectasis group. Overall, 823 patients were enrolled. The mean age was 66.0 ± 13.9 years, and 63.4% were men. Bronchiectasis and severe bronchiectasis were present in 148 (18.0%) and 108 (13.1%) patients, respectively. The increase in the number of bronchiectatic lobes was related to the rise in ICU mortality (P for trend = 0.012) and in-hospital mortality (P for trend = 0.004). Patients with severe bronchiectasis had higher odds for 28-day mortality [odds ratio (OR) 1.122, 95% confidence interval (CI) 1.024–1.230], ICU mortality (OR 1.119, 95% CI 1.023–1.223), and in-hospital mortality (OR 1.208, 95% CI 1.092–1.337). The severe bronchiectasis group showed lower overall survival (log-rank P < 0.001), and the adjusted hazard ratio was 1.535 (95% CI 1.178–2.001). Severe bronchiectasis had a negative impact on all-cause mortality during ICU and hospital stays, resulting in a lower survival rate.

scholarly journals Early liver injury is closely related to organ failure of sepsis

2020 ◽  
Author(s):  
Milin Peng ◽  
Yuhang Ai ◽  
Lina Zhang ◽  
Shuangping Zhao ◽  
Zhiyong Liu ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Liver Injury ◽  
Renal Dysfunction ◽  
Organ Failure ◽  
Rank Test ◽  
Apache Ii Score ◽  
Icu Admission ◽  
Kaplan Meier ◽  
Injury Group ◽  
The Impact

Abstract Backgrounds: Sepsis induced organ failure is main cause of mortality in intensive care units (ICU), however, the impact of early liver injury on clinical ending of sepsis is not clear and has not been discussed in context of clinical research on sepsis before. Our study aimed at the investigation of the clinical effect of early liver injury within 48h at ICU admission on sepsis outcomes. Methods: A single-centered, retrospective cohort of 198 adult critical patients diagnosed with sepsis were included in different ICU departments of Xiangya hospital from 2016 to 2018. Patients were divided into two groups, early liver injury and non-early liver injury within 48h at ICU admission. Baseline characteristics, clinical outcomes and risk factors of these two groups were studied. Logistic regression analysis, Cox hazard analysis, Kaplan-Meier and log-rank test were used. Results: In total, 198 patients with sepsis were included, with 106 (53.5%) with early liver injury and overall in-hospital mortality was 45.9% (n=91). Compared to non-early liver injury group, patients with early liver injury had significant higher SOFA (7.44±3.83 vs. 5.55±2.61, P<0.001), APACHE II score (15.22±23.14 vs. 9.14±8.72, P=0.013) , procalcitonin (37.10±59.20 vs. 19.24±48.10, P=0.021) , and rate of shock (63.2% vs. 48.9%, P=0.046). Primary outcome showed that early liver injury group had significant higher rate of renal dysfunction (62.3 vs. 33.7%, P<0.001), coagulation (31.1% vs. 13.0%, P=0.004) and hematologic system (72.6% vs. 52.2%, P=0.003) dysfunction hinting at higher organ failure rate. Age (OR 0.966; 95% CI 0.944-0.989; P=0.004), hypertriglyceridemia (OR 1.636; 95% CI 1.049-2.551; P=0.030), serum total bile acid (TBA, OR 1.071; 95% CI 1.030-1.113; P=0.001), hemoglobin (OR 1.030; 95% CI 1.013-1.046; P<0.001) and renal dysfunction (OR 3.403; 95% CI 1.631-7.099; P=0.001) were the independent predictors for early liver injury in sepsis by multiple regression analysis. Kaplan-Meier survival analyze demonstrated early liver injury and non-early liver injury group had similar survival time. Conclusion: Early liver injury within 48 hours on ICU admission is closely related to organ failure for patients with sepsis. Future study with big data is required to verify our viewpoint.

Rapid Muscle Loss Negatively Impacts Survival in Critically Ill Patients With Cirrhosis

2018 ◽  
Vol 35 (7) ◽  
pp. 663-671 ◽  
Author(s):  
Sunmi Ju ◽  
Sun Mi Choi ◽  
Young Sik Park ◽  
Chang-Hoon Lee ◽  
Sang-Min Lee ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Critically Ill ◽  
Muscle Mass ◽  
Critically Ill Patients ◽  
Mass Change ◽  
Apache Ii Score ◽  
Muscle Loss ◽  
Icu Mortality ◽  
Skeletal Muscle Index ◽  
The Impact

Purpose: To assess the impact of rapid muscle loss before admission to intensive care unit (ICU) in critically ill patients with cirrhosis. Materials and Methods: Patients with cirrhosis who had undergone 2 or more recent computed tomography scans before admission to the medical ICU were included. Muscle cross-sectional area at the level of the third lumbar vertebra was quantified using OsiriX software. The rate of muscle mass change and skeletal muscle index (SMI) were also calculated. Multivariable Cox proportional hazards regression was used to evaluate the association between muscle loss and mortality. Results: Among 125 patients, 113 (90.4%) patients were classified as having sarcopenia. The mean body mass index was 22.6 (3.9) kg/m2. Thirty-nine (31.2%) patients were within the normal range for muscle mass change, while 86 (68.8%) patients demonstrated rapid decline in muscle mass before admission to the ICU. Patients with rapid muscle loss showed high ICU mortality (59.3%) and in-hospital mortality (77.9%). Multivariate Cox analysis showed that ICU mortality and in-hospital mortality were independently associated with malignancy, Acute Physiology and Chronic Health Evaluation (APACHE) II score, SMI, and rapid muscle loss. Conclusion: Rapid muscle decline is correlated with increased ICU mortality and in-hospital mortality in critically ill patients with cirrhosis.

scholarly journals Relative platelet reductions provide better pathophysiologic signatures of coagulopathies in sepsis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Daisuke Kasugai ◽  
Masayuki Ozaki ◽  
Kazuki Nishida ◽  
Yukari Goto ◽  
Kunihiko Takahashi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Hospital Mortality ◽  
Logistic Regression Analysis ◽  
Mortality Risk ◽  
The United States ◽  
Research Database ◽  
Mixed Effect ◽  
Platelet Counts ◽  
The Impact

AbstractIn sepsis-associated coagulopathies and disseminated intravascular coagulation, relative platelet reductions may reflect coagulopathy severity. However, limited evidence supports their clinical significance and most sepsis-associated coagulopathy criteria focus on the absolute platelet counts. To estimate the impact of relative platelet reductions and absolute platelet counts on sepsis outcomes. A multicenter retrospective observational study was performed using the eICU Collaborative Research Database, comprising 335 intensive care units (ICUs) in the United States. Patients with sepsis and an ICU stay > 2 days were included. Estimated effects of relative platelet reductions and absolute platelet counts on mortality and coagulopathy-related complications were evaluated. Overall, 26,176 patients were included. Multivariate mixed-effect logistic regression analysis revealed marked in-hospital mortality risk with larger platelet reductions between days one and two, independent from the resultant absolute platelet counts. The adjusted odds ratio (OR) [95% confidence intervals (CI)] for in-hospital mortality was 1.28[1.23–1.32], 1.86[1.75–1.97], 2.99[2.66–3.36], and 6.05[4.40–8.31] for 20–40%, 40–60%, 60–80%, and > 80% reductions, respectively, when compared with a < 20% decrease in platelets (P < 0.001 for each). In the multivariate logistic regression analysis, platelet reductions ≥ 11% and platelet counts ≤ 100,000/μL on day 2 were associated with high coagulopathy-related complications (OR [95%CI], 2.03 and 1.18; P < 0.001 and P < 0.001), while only platelet reduction was associated with thromboembolic complications (OR [95%CI], 1.43 [1.03–1.98], P < 0.001). The magnitude of platelet reductions represent mortality risk and provides a better signature of coagulopathies in sepsis; therefore, it is a plausible criterion for sepsis-associated coagulopathies.

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