Fibrinogen, Coagulation Times and Some Inflammation Markers In Patients with Different Stages of Sepsis

Prospective non interventional study on patients with Sp, from November 2009–2010

Medicine hospitalization areas in a single third level hospital in western México

One hundred and eighty eight patients with Sp who were admitted to Medicine wards received standard critical care treatment.

Patients were stratified into Sp, severe Sp and septic shock. Mortality was assessed at discharge and clotting test and inflammation markers were measured at admission and at discharge

Sp incidence was 9.6%. There were 114 patients with Sp, 57 severe Sp and 17 with septic shock; the mortality for the group was 23%; 6%, 34%, and 94% in Sp, severe Sp, and septic shock respectively. Initial fibrinogen (Fg) showed a trend to be higher as clinical stages of Sp advanced (346, 361,393 mg PNS), and final Fg decreased in Sp** and severe Sp* and shock (PNS). PT** and PTT** at discharge, were prolonged. Initial and final bands* were higher as the stages of Sp increased and decreased at discharge, except in those with septic shock. Comparing results by survivorship it was observed that initially and at discharge, non survivors had greater abnormalities of PT**, PTT**, and bands** than survivors. Fg**was lower in those who died

The trend of the Initial Fg levels to increase as severity of Sp, its decrease at discharge, the prolongation of PT and PTT and the descend of platelets, suggest that the activation of the coagulation cascade increases as Sp progresses and, that this could be related to the severity of the inflammatory response and the vascular damage. The coagulopathy is suggestive of DIC andthat this participates in the prognosis. It would be important to set the clinical role of coagulation in the stages of Sp. A mayor numbers of patients must be studied and markers of DIC investigated.

No relevant conflicts of interest to declare.