Sepsis-induced coagulopathy (SIC) score is an independent predictor of mortality and overt-disseminated intravascular coagulation in emergency department patients with sepsis

Sepsis is frequently associated with coagulation anomalies which can contribute to multiple organ dysfunction and death through a mechanism of microvascular thrombosis and possible evolution to consumption coagulopathy. The recently introduced SIC (sepsis-induced coagulopathy) score was developed for the early identification of sepsis-associated coagulopathy. This study aims to evaluate the predictive value of the SIC score for in-hospital mortality and clinically significant complications in emergency department (ED) patients with sepsis. This is a retrospective, observational cohort study including patients with a diagnosis of sepsis admitted to the hospital after an ED evaluation in a period of one year (January 2021 to December 2021). The SIC score was retrospectively calculated from the electronic clinical records of our hospital. The primary outcome was in-hospital mortality; secondary outcomes were coagulopathy-related clinical complications (disseminated intravascular coagulation, bleeding, thrombosis, blood component transfusion, and organ injury). Univariate and multivariate logistic regression analyses were used to assess the association between a positive SIC score and the study endpoints. The study cohort consisted of 357 septic patients. Overall, 82 (23.0%) patients died during hospital stay, and 27 patients (7.6%) developed overt disseminated intravascular coagulation (DIC) At multivariate logistic regression analysis, a positive SIC score at ED admission was an independent predictor of in-hospital mortality, with an Odd Ratio (OR) of 2.28 (95% confidence interval, 1.16–4.48). In addition, the SIC score was an independent predictor for the development of overt-DIC (OR 10.39, (95% CI, 4.08–26.46)), new organ injury (OR 6.33, (95% CI, 2.90–13.83)), bleeding (OR 4.83, (95% CI, 2.22–10.50)) and thrombotic events (OR 9.48, (95% CI, 2.95–30.40)), as well as the need for blood component transfusion (OR 5.28, (95% CI, 2.35–11.83)). In ED patients with sepsis, the SIC score is an early predictor of in-hospital mortality and the development of severe coagulopathy-related complications.

Sepsis; Septic coagulopathy; Disseminated intravascular coagulation; SIC score; Emergency department

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