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Sepsis-induced coagulopathy and outcomes - What about bleeding? : A propensity score-matched study in critically ill patients with septic shock

Víðisson, Kristján LU orcid ; Kander, Thomas LU orcid ; Lengquist, Maria LU orcid ; Mellhammar, Lisa LU orcid ; Linder, Adam LU and Nilsson, Caroline Ulfsdotter LU (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.

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author
; ; ; ; and
organization
publishing date
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}},
}