Response patterns of routinely measured inflammatory and coagulatory parameters in sepsis
Background Sepsis is characterized by a pro-inflammatory and pro-coagulatory shift which can induce life-threatening complications. Close monitoring and risk stratification of sepsis patients is crucial for proper treatment and consequently patient outcome. Therefore, this study focuses on the respo...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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PeerJ Inc.
2019-06-01
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| Online Access: | https://peerj.com/articles/7147.pdf |
| _version_ | 1797422168310546432 |
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| author | Mirjam Bachler Tobias Hell Lukas Schausberger Christine Schlömmer Volker Schäfer Marlies Liebensteiner Katharina Schäffler Bettina Schenk Dietmar Fries Petra Innerhofer Christian Niederwanger |
| author_facet | Mirjam Bachler Tobias Hell Lukas Schausberger Christine Schlömmer Volker Schäfer Marlies Liebensteiner Katharina Schäffler Bettina Schenk Dietmar Fries Petra Innerhofer Christian Niederwanger |
| author_sort | Mirjam Bachler |
| collection | DOAJ |
| description | Background Sepsis is characterized by a pro-inflammatory and pro-coagulatory shift which can induce life-threatening complications. Close monitoring and risk stratification of sepsis patients is crucial for proper treatment and consequently patient outcome. Therefore, this study focuses on the response patterns of inflammatory and coagulatory parameters used in clinical routines to estimate the course of sepsis. Methods A total of 1,110 patients diagnosed with sepsis were retrospectively analyzed to identify response patterns for risk stratification of routine parameters measured at the peak level of C-reactive protein. Cluster analysis was used and the differences in the patient characteristics and 28-day survival were assessed. Cox proportional hazards regression model for survival stratified by the clusters was performed. Results The analyses revealed the parameters to have five distinct response patterns. These clusters reflect the etiology as well as the course of sepsis associated with different mortalities. Here, impairment of the liver plays a crucial role in the ability to appropriately respond to sepsis. Of the routinely measured parameters, C-reactive protein and antithrombin seem to be unspecific for stratification of septic patients. Adjusted for the individual clusters, survival was associated with an increase in fibrinogen (p = 0.0042), platelets (p = 0.0003) and PT (p = 0.001) as well as a decrease in leukocytes (p = 0.034). Conclusions This study reveals that patients have distinct response patterns of inflammatory and coagulatory parameters depending on disease etiology. These patterns are associated with different mortalities although the patients have similar levels of C-reactive protein. Independently of the type of response, good coagulatory capacity seems to be crucial for patient survival. |
| first_indexed | 2024-03-09T07:28:17Z |
| format | Article |
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| issn | 2167-8359 |
| language | English |
| last_indexed | 2024-03-09T07:28:17Z |
| publishDate | 2019-06-01 |
| publisher | PeerJ Inc. |
| record_format | Article |
| series | PeerJ |
| spelling | doaj.art-77fb9293ebf94c99b984bc799b4cbd942023-12-03T06:47:52ZengPeerJ Inc.PeerJ2167-83592019-06-017e714710.7717/peerj.7147Response patterns of routinely measured inflammatory and coagulatory parameters in sepsisMirjam Bachler0Tobias Hell1Lukas Schausberger2Christine Schlömmer3Volker Schäfer4Marlies Liebensteiner5Katharina Schäffler6Bettina Schenk7Dietmar Fries8Petra Innerhofer9Christian Niederwanger10University for Health Sciences, Medical Informatics and Technology, Institute for Sports Medicine, Alpine Medicine and Health Tourism, Hall, AustriaDepartment of Mathematics, Faculty of Mathematics, Computer Science and Physics, University of Innsbruck, Innsbruck, AustriaDepartment of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of General and Surgical Critical Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Innsbruck, AustriaDepartment of Pediatrics, Pediatrics I, Medical University of Innsbruck, Innsbruck, AustriaBackground Sepsis is characterized by a pro-inflammatory and pro-coagulatory shift which can induce life-threatening complications. Close monitoring and risk stratification of sepsis patients is crucial for proper treatment and consequently patient outcome. Therefore, this study focuses on the response patterns of inflammatory and coagulatory parameters used in clinical routines to estimate the course of sepsis. Methods A total of 1,110 patients diagnosed with sepsis were retrospectively analyzed to identify response patterns for risk stratification of routine parameters measured at the peak level of C-reactive protein. Cluster analysis was used and the differences in the patient characteristics and 28-day survival were assessed. Cox proportional hazards regression model for survival stratified by the clusters was performed. Results The analyses revealed the parameters to have five distinct response patterns. These clusters reflect the etiology as well as the course of sepsis associated with different mortalities. Here, impairment of the liver plays a crucial role in the ability to appropriately respond to sepsis. Of the routinely measured parameters, C-reactive protein and antithrombin seem to be unspecific for stratification of septic patients. Adjusted for the individual clusters, survival was associated with an increase in fibrinogen (p = 0.0042), platelets (p = 0.0003) and PT (p = 0.001) as well as a decrease in leukocytes (p = 0.034). Conclusions This study reveals that patients have distinct response patterns of inflammatory and coagulatory parameters depending on disease etiology. These patterns are associated with different mortalities although the patients have similar levels of C-reactive protein. Independently of the type of response, good coagulatory capacity seems to be crucial for patient survival.https://peerj.com/articles/7147.pdfFibrinogenC-reactive proteinInflammationCoagulationPlateletsSepsis |
| spellingShingle | Mirjam Bachler Tobias Hell Lukas Schausberger Christine Schlömmer Volker Schäfer Marlies Liebensteiner Katharina Schäffler Bettina Schenk Dietmar Fries Petra Innerhofer Christian Niederwanger Response patterns of routinely measured inflammatory and coagulatory parameters in sepsis PeerJ Fibrinogen C-reactive protein Inflammation Coagulation Platelets Sepsis |
| title | Response patterns of routinely measured inflammatory and coagulatory parameters in sepsis |
| title_full | Response patterns of routinely measured inflammatory and coagulatory parameters in sepsis |
| title_fullStr | Response patterns of routinely measured inflammatory and coagulatory parameters in sepsis |
| title_full_unstemmed | Response patterns of routinely measured inflammatory and coagulatory parameters in sepsis |
| title_short | Response patterns of routinely measured inflammatory and coagulatory parameters in sepsis |
| title_sort | response patterns of routinely measured inflammatory and coagulatory parameters in sepsis |
| topic | Fibrinogen C-reactive protein Inflammation Coagulation Platelets Sepsis |
| url | https://peerj.com/articles/7147.pdf |
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