Coagulation in hospitalized community-acquired pneumonia: disturbances in even the least ill
© BioMed Central Ltd 2008
Published: 13 March 2008
Although previous studies of severe sepsis (SS) patients found coagulopathy quite common, little is known of coagulopathy in infection with lesser degrees of illness severity.
In a 28-center prospective cohort study (GenIMS) of patients presenting to US emergency departments with community-acquired pneumonia, we measured serum coagulation markers (INR, partial thromboplastin time, platelets, antithrombin, D-dimer, factor IX, prothrombin activator-inhibitor (PAI) and thrombin–antithrombin (TAT)) on emergency department presentation. We stratified the proportion of subjects with abnormal values by illness severity (APACHE III), subsequent development of SS, and 90-day mortality. We hypothesized coagulation abnormalities would increase with illness severity and be greater in those with poor outcomes.
Coagulation abnormalities are common in hospitalized community-acquired pneumonia patients, increasing with illness severity and poor outcome. Abnormalities were seen even in the least ill, however, and differences between groups were not large. Therapeutic manipulation of coagulation in infection will probably require a carefully titrated approach.
Supported by NIGMS R01GM61992.
This article is published under license to BioMed Central Ltd.