Superiority of a combined antithrombin and activated protein C model for predicting coagulopathy and mortality in pneumonia-related sepsis: A prospective cohort study
Abstract
BACKGROUND
Pneumonia-related sepsis is frequently complicated by coagulation disorders, which significantly increase mortality risk. The current ISTH criteria demonstrate limited sensitivity in diagnosing pneumonia-specific coagulopathy, and the mechanisms underlying clinical phenotypic heterogeneity remain poorly understood. There is a growing need to identify novel biomarkers that can enhance the early detection and stratification of disseminated intravascular coagulation (DIC), particularly in its non-overt stages.
AIMS
The study aimed to evaluate the prognostic value of antithrombin (AT) and activated protein C (aPC) testing for predicting clinical deterioration and early DIC progression in adults with severe pneumonia-related sepsis.
METHODS
We conducted a prospective observational cohort study of 86 adults with severe pneumonia-related sepsis admitted to the Intensive Care Unit (ICU). All patients underwent testing of AT and aPC upon enrollment. The predictive value of this biomarker combination was evaluated for the development of overt DIC within 72 h and 28-day all-cause mortality using receiver operating characteristic (ROC) analysis.
RESULTS
Among 86 adults with severe pneumonia-related sepsis (median age 65 years; 56.9 % male), 18 (20.9 %) progressed to overt DIC within 72 h, and the 28-day mortality rate was 26.7 % (23/86). Compared with survivors, non-survivors exhibited significantly lower antithrombin activity (median 65 % vs. 78 %; P = 0.005) and higher…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 86 participants or records.
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