Hemostasis biomarkers and risk of sepsis: the REGARDS cohort

被引:16
作者
Moore, J. X. [1 ,2 ]
Zakai, N. A. [3 ,4 ]
Mahalingam, M. [5 ]
Griffin, R. L. [3 ,4 ]
Irvin, M. R. [3 ,4 ]
Safford, M. M. [6 ]
Baddley, J. W. [7 ]
Wang, H. E. [1 ]
机构
[1] Univ Alabama Birmingham, Dept Emergency Med, 619 19th St South,OHB 251, Birmingham, AL 35249 USA
[2] Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA
[3] Univ Vermont, Coll Med, Colchester Res Facil, Dept Med, Colchester, VT USA
[4] Univ Vermont, Coll Med, Colchester Res Facil, Dept Pathol, Colchester, VT USA
[5] Univ Alabama Birmingham, Dept Med, Birmingham, AL 35294 USA
[6] Weill Cornell Med Ctr, Dept Med, New York, NY USA
[7] Univ Alabama Birmingham, Dept Med, Div Infect Dis, Birmingham, AL 35294 USA
基金
美国国家卫生研究院;
关键词
epidemiology; factor IX; factor VIII; factor XI; fibrinogen; sepsis; CRITICALLY-ILL PATIENTS; CHRONIC KIDNEY-DISEASE; ABO BLOOD-TYPE; RACIAL-DIFFERENCES; UNITED-STATES; VENOUS THROMBOEMBOLISM; ORGAN DYSFUNCTION; STROKE RISK; REASONS; EPIDEMIOLOGY;
D O I
10.1111/jth.13446
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Background: Sepsis is a major public health concern, responsible for more than 750 000 hospitalizations and 200 000 annual deaths in the USA. Few studies have investigated the association between baseline measurements of hemostasis biomarkers and the future risk of sepsis. Objective: To determine whether hemostasis biomarkers levels measured at baseline in a cohort of community-dwelling participants are associated with the risk of future sepsis events. Methods: We performed a nested case-control study within the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We identified sepsis hospitalizations occurring over a 10-year period. There were 50 incident sepsis cases with baseline measurements of hemostasis (fibrinogen, factor VIII, FIX, FXI, protein C, and D-dimer). Using incidence density sampling, we matched the 50 sepsis cases with 200 controls by age, sex, and race. We used conditional logistic regression to evaluate the association between baseline hemostasis biomarkers and future sepsis events. Results: Comparison of 50 sepsis cases with 200 non-sepsis controls showed that sepsis cases had lower education and income, were more likely to live in the stroke belt, had chronic lung disease, and had higher albumin level/creatinine level ratios (ACRs). Individuals with higher baseline fibrinogen levels (adjusted odds ratio [OR] per standard deviation: 1.40, 95% confidence interval [CI] 1.01-1.94), FIX levels ([OR] 1.46, 95% [CI] 1.03-2.07) and FXI levels ([OR] 1.52, 95% [CI] 1.04-2.23) were more likely to experience a sepsis event. Conclusion: Baseline fibrinogen, FIX and FXI levels are associated with future episodes of sepsis. Hemostasis biomarkers may provide targets for sepsis mitigation or prevention.
引用
收藏
页码:2169 / 2176
页数:8
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