Sepsis-induced coagulopathy and outcomes - What about bleeding? : A propensity score-matched study in critically ill patients with septic shock
(2026) In Journal of Critical Care 94.- Abstract
BACKGROUND: Sepsis-induced coagulopathy (SIC) is a scoring system developed for early detection of coagulopathy in sepsis and selection of patients for interventional studies. Our aim was to define the prevalence of SIC in a critically ill population and investigate if SIC at intensive care unit (ICU) admission is associated with morbidity and mortality.
METHODS: Patients admitted with septic shock between 2011, and March 2024 were propensity matched into 2 groups (control and SIC). Primary outcome was 28-day mortality. Other outcomes were 90-, 180-day and ICU-mortality, days alive and free of vasopressors, mechanical ventilation and renal replacement therapy (RRT) along with the use of RRT, number of critical bleeding events and... (More)
BACKGROUND: Sepsis-induced coagulopathy (SIC) is a scoring system developed for early detection of coagulopathy in sepsis and selection of patients for interventional studies. Our aim was to define the prevalence of SIC in a critically ill population and investigate if SIC at intensive care unit (ICU) admission is associated with morbidity and mortality.
METHODS: Patients admitted with septic shock between 2011, and March 2024 were propensity matched into 2 groups (control and SIC). Primary outcome was 28-day mortality. Other outcomes were 90-, 180-day and ICU-mortality, days alive and free of vasopressors, mechanical ventilation and renal replacement therapy (RRT) along with the use of RRT, number of critical bleeding events and red blood cell transfusion.
RESULTS: 1367 patients with septic shock were identified, 422 (31%) had SIC at ICU admission. Propensity matching resulted in 340 patients in each group. SIC was not associated with higher 28-day mortality (44% versus 37%, p = 0.091). ICU-mortality was higher in the SIC group (30% versus 22%, p = 0.016) and it had fewer median days alive and free of vasopressors (20 versus 22, p = 0.046). Incidence of critical bleeding events was higher in the SIC group (17% versus 10%, p = 0.009). More patients in the SIC group required red blood cell transfusion (63% versus 53%, p = 0.009). There was no significant difference in other outcomes.
CONCLUSION: SIC was prevalent in 31% of patients at ICU admission and was associated with higher ICU-mortality, fewer days alive and free of vasopressors, more critical bleeding events and more red blood cell transfusions.
(Less)
- author
- Víðisson, Kristján
LU
; Kander, Thomas
LU
; Lengquist, Maria
LU
; Mellhammar, Lisa
LU
; Linder, Adam
LU
and Nilsson, Caroline Ulfsdotter
LU
- organization
-
- Clinical Research in Anaesthesia and Intensive Care Medicine (research group)
- Anesthesiology and Intensive Care
- Teachers at the Medical Programme
- SWECRIT (research group)
- Infect@LU
- Translational Sepsis research (research group)
- Infection Medicine (BMC)
- Heparin bindning protein in cardiothoracic surgery (research group)
- SEBRA Sepsis and Bacterial Resistance Alliance (research group)
- publishing date
- 2026-03-27
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Critical Care
- volume
- 94
- article number
- 155542
- publisher
- Elsevier
- external identifiers
-
- scopus:105033634263
- pmid:41903245
- ISSN
- 1557-8615
- DOI
- 10.1016/j.jcrc.2026.155542
- project
- Aspects of sepsis-induced coagulopathy
- language
- English
- LU publication?
- yes
- id
- 2b12fbe9-1bc8-47e5-a22f-24acac2c15ce
- date added to LUP
- 2026-03-30 06:35:39
- date last changed
- 2026-06-10 10:15:53
@article{2b12fbe9-1bc8-47e5-a22f-24acac2c15ce,
abstract = {{<p>BACKGROUND: Sepsis-induced coagulopathy (SIC) is a scoring system developed for early detection of coagulopathy in sepsis and selection of patients for interventional studies. Our aim was to define the prevalence of SIC in a critically ill population and investigate if SIC at intensive care unit (ICU) admission is associated with morbidity and mortality.</p><p>METHODS: Patients admitted with septic shock between 2011, and March 2024 were propensity matched into 2 groups (control and SIC). Primary outcome was 28-day mortality. Other outcomes were 90-, 180-day and ICU-mortality, days alive and free of vasopressors, mechanical ventilation and renal replacement therapy (RRT) along with the use of RRT, number of critical bleeding events and red blood cell transfusion.</p><p>RESULTS: 1367 patients with septic shock were identified, 422 (31%) had SIC at ICU admission. Propensity matching resulted in 340 patients in each group. SIC was not associated with higher 28-day mortality (44% versus 37%, p = 0.091). ICU-mortality was higher in the SIC group (30% versus 22%, p = 0.016) and it had fewer median days alive and free of vasopressors (20 versus 22, p = 0.046). Incidence of critical bleeding events was higher in the SIC group (17% versus 10%, p = 0.009). More patients in the SIC group required red blood cell transfusion (63% versus 53%, p = 0.009). There was no significant difference in other outcomes.</p><p>CONCLUSION: SIC was prevalent in 31% of patients at ICU admission and was associated with higher ICU-mortality, fewer days alive and free of vasopressors, more critical bleeding events and more red blood cell transfusions.</p>}},
author = {{Víðisson, Kristján and Kander, Thomas and Lengquist, Maria and Mellhammar, Lisa and Linder, Adam and Nilsson, Caroline Ulfsdotter}},
issn = {{1557-8615}},
language = {{eng}},
month = {{03}},
publisher = {{Elsevier}},
series = {{Journal of Critical Care}},
title = {{Sepsis-induced coagulopathy and outcomes - What about bleeding? : A propensity score-matched study in critically ill patients with septic shock}},
url = {{http://dx.doi.org/10.1016/j.jcrc.2026.155542}},
doi = {{10.1016/j.jcrc.2026.155542}},
volume = {{94}},
year = {{2026}},
}