Combination of antithrombin and soluble thrombomodulin for early prediction of sepsis-Induced disseminated intravascular coagulation

作者：Huan Zeng, Jianming Wei, Jiujiang Zeng, Yuexi Sun, Mengmeng Wang, Guoxing Dai, Yanli Song · 发表于：Thrombosis Journal · 年份：2025 · DOI：10.1186/s12959-025-00783-z · 被引用次数：2 · 研究领域：Sepsis Diagnosis and Treatment、Trauma, Hemostasis, Coagulopathy, Resuscitation、Hemodynamic Monitoring and Therapy

BACKGROUND: To identify early diagnostic biomarkers for sepsis-induced disseminated intravascular coagulation, we investigated the relationship between the novel coagulation biomarkers and antithrombin with the development of Disseminated intravascular coagulation post-admission, as well as the prognosis of patients with sepsis. METHODS: We retrospectively collected data from septic patients admitted to the Emergency Intensive Care Unit (EICU) of a teaching hospital between October 2021 and September 2023. Multivariate logistic regression analysis was performed to identify risk factors, and receiver operating characteristic (ROC) curve analysis was used to assess the performance of the predictive model. In addition, non-parametric bootstrap analysis with 1,000 replications was conducted to evaluate the internal stability and empirical power of the predictive models, particularly given the limited sample size. RESULTS: Among 91 septic patients, 15 were diagnosed with DIC. Soluble thrombomodulin (OR: 1.28, 95% CI: 1.033-1.586, P = 0.024) and antithrombin activity (OR: 0.887, 95% CI: 0.792-0.994, P = 0.039) were identified as independent risk factors for the development of DIC in septic patients. The area under the curve (AUC) for soluble thrombomodulin and antithrombin was 0.788 and 0.757, respectively. When combined, the AUC increased to 0.858. Prothrombin Time (HR: 1.058, 95% CI: 1.016-1.102, P = 0.007) and APACHE II score (HR: 1.071, 95% CI: 1.005-1.141, P = 0.035) were iden...