Hematologic System Dysregulation in Critically Ill Septic Patients with Anemia—A Retrospective Cohort Study

Sepsis can affect various organs as well as the hematologic system. Systemic dysregulation, present in sepsis, affects particularly red blood cells (RBCs). One of the widely available RBC indices is RBC distribution width (RDW). Sepsis may also affect hemostasis, with septic patients presenting with coagulopathy or disseminated intravascular coagulation. The aim of our study was to analyze the impact of sepsis on RBC indices and coagulation parameters on admission to the intensive care unit (ICU) and their association with presence of sepsis and sepsis outcomes in anemic critically ill patients. We performed a retrospective observational study covering consecutive patients admitted to a 10-bed mixed ICU in the years 2020−2021. We found significant differences between septic and non-septic patients for the following parameters: RDW (p = 0.02), INR (p 1.21. Combination of INR with fibrinogen and a severity of disease score improved INR’s predictive value (AUROC 0.74−0.77). Combination of INR with a severity of disease score was an adequate ICU mortality predictor in septic patients (AUROC 0.70−0.75). Sepsis significantly affects RDW and most coagulation parameters. Increased INR can be used for sepsis screening, whereas combination of INR with a severity of disease score can be a predictor of short-term mortality in septic patients

Anemia · Coagulopathy · Disseminated intravascular coagulation · Intensive care medicine · Intensive care unit · Red blood cell distribution width · Retrospective cohort study · Sepsis · Septic shock · Severity of illness · Hematological disorders and diagnostics · Hemodynamic Monitoring and Therapy · Medicine · Sepsis Diagnosis and Treatment · Gastroenterology · Internal Medicine

• The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

  Mervyn Singer, Clifford S Deutschman et al.•JAMA•2016

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