ĐẶC ĐIỂM RỐI LOẠN ĐÔNG MÁU Ở BỆNH NHÂN NHIỄM KHUẨN NẶNG, SỐC NHIỄM KHUẨN TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI TRUNG ƯƠNG NĂM 2019

Abstract

Sepsis - induced - coagulopathy (SIC) is a very common problem of septic patients that could increase mortality of patients. Studies on this field in Vietnam is still limited. Objectives: This study aims to evaluate the prevalence and manifestation of SIC in sepsis and septic shock patients at the National Hospital for Tropical Diseases (NHTD) in 2019.

Subjects and methods: Cross - sectional descriptive and prospective study. All patients who were diagnosed sepsis according to Surviving Sepsis Campaign (SSC) 2016 and treated at NHTD from April 15th to November 20th in 2019 were enrolled in this study. Patients were assessed with SIC score and evaluated coagulopathy characteristics with in the first 24 hours after admission.

Results: 102 patients involved the study, the average age was 57 years old, the male was 75%, septic shock appeared in 65% of patients, the average SOFA score was 9. The prevalence of SIC was 70.5%, 41% of patients showed hemorrhage in clinical, the proportion of thrombocytopenia was 69%, patients with decreased fibrinogen were only 20.6%. Of 57 patients had coagulopathy evaluated by ROTEM method, the proportion of hypocoagulation and hypercoagulation were respectively 58% and 10.5%; high fibrinogen ratio was 41.5%, 100% cases had increased of DDimer in plasma, overt - DIC (ISTH) was diagnosed in 45.1% of patients, 20% of patients were suspected suffering from TTP-HUS. Conclusions: The prevalence of SIC was very high at 70.5%, the manifestation of SIC was very diverse.