Biomarker-based assessment for predicting sepsis-induced coagulopathy and outcomes in intensive care

Background: Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, leading to acquired coagulopathy and disseminated intravascular coagulation (DIC) with suppressed fibrinolytic activity. Currently, practical prognostic tools for assessing morbidity and mortality from sepsis-induced coagulopathy are insufficient, especially in emergency settings and the ICU. Aim: This study aimed to compare recently updated DIC scoring systems and emerging coagulopathy biomarkers for their efficacy in predicting sepsis-induced DIC and subsequent outcomes in ICU patients with sepsis. Methods: We conducted a retrospective cohort study involving 88 patients newly diagnosed with sepsis who progressed to DIC and were admitted to the ICU. Comprehensive clinical evaluations and blood sampling were performed for analysis upon admission and 48 h post-diagnosis of sepsis. Results: Our research indicates that the NLR and JAAM-2 DIC score are more reliable in predicting sepsis-induced DIC, as early as the first two days following sepsis diagnosis. Early PAI-1 measurements are powerful prognostic indicators of patient outcomes and 7-day mortality, surpassing the results of traditional tests. Conclusions: This study emphasizes the importance of incorporating early sequential assessments of NLR, the JAAM-2 DIC score, and PAI-1 into early screening protocols for ICU sepsis patients and emergency settings, thereby facilitating the prompt diagnosis of DIC, effective anticoagulant management, and improved survival rates.