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Clinical value of automated fibrin generation markers in patients with septic shock: a SepsiCoag ancillary study

Authors :
Pauline Deras
Jean-Michel Constantin
Eva Cochery-Nouvellon
Jean-Yves Lefrant
Loubna Elotmani
Samir Jaber
Géraldine Lavigne-Lissalde
Jacques Albanèse
Jean-Christophe Orban
Sylvie Bouvier
Jerôme Morel
Jean-Christophe Gris
Marc Leone
Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992)
Université Montpellier 1 (UM1)-Université de Montpellier (UM)
Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes)
Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)
Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp)
Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
CHU Clermont-Ferrand
Centre Hospitalier Universitaire de Nice (CHU Nice)
Department of Intensive Care
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE)
Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE)
Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48
Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48
Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne)
Saint Etienne University Hospital
INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48
INSB-INSB-Centre National de la Recherche Scientifique (CNRS)
Source :
British Journal of Haematology, British Journal of Haematology, 2018, pp.636-647. ⟨10.1111/bjh.15576⟩, British Journal of Haematology, Wiley, 2018, pp.636-647. ⟨10.1111/bjh.15576⟩
Publication Year :
2018
Publisher :
HAL CCSD, 2018.

Abstract

An ancillary analysis to the SepsiCoag multicentric prospective observational study on patients entering an intensive care unit with septic shock evaluated the prognostic potential of fibrin generation markers (FGMs) tested at inclusion in the study, on survival at day 30. After centralization of samples, three automated FGMs were compared: D-dimers (DDi), fibrin/fibrinogen degradation products (FDP) and fibrin monomers (FM). FM was the single FGM that was significantly higher in non-surviving patients, area under the receiver-operator characteristic curve (AUCROC ): 0·617, P < 0·0001. Significantly higher International Society on Thrombosis and Haemostasis Disseminated Intravascular Coagulation (ISTH DIC) scores were calculated in non-survivors using each of the three FGMs. A dose-effect relationship was observed between ISTH DIC scores and non-survival, with highest significance obtained using FM as the FGM. An overt DIC diagnosis using the ISTH DIC score calculated using FM was a predictor of non-survival at day 30, independently from overt DIC diagnosis based on scores calculated using FDP or DDi. The AUCROC values testing the ability of the ISTH DIC score to predict non-survival were 0·650, 0·624 and 0·602 using FM, DDi and FDP, respectively, as the FGM. In patients with septic shock, among the commercially-available automated assays, automated FM is the FGM best related with late prognosis.

Details

Language :
English
ISSN :
00071048 and 13652141
Database :
OpenAIRE
Journal :
British Journal of Haematology, British Journal of Haematology, 2018, pp.636-647. ⟨10.1111/bjh.15576⟩, British Journal of Haematology, Wiley, 2018, pp.636-647. ⟨10.1111/bjh.15576⟩
Accession number :
edsair.doi.dedup.....d4f8070006100b86dcaf87a6e6c61daa
Full Text :
https://doi.org/10.1111/bjh.15576⟩