z-logo
Premium
Increased mortality in systemic inflammatory response syndrome patients with high levels of coagulation factor VIIa
Author(s) -
Hyseni A.,
Kemperman H.,
Lange D. W.,
Groot P. G.,
Linssen M.,
Kesecioglu J.,
Lisman T.,
Roest M.
Publication year - 2013
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12427
Subject(s) - medicine , systemic inflammatory response syndrome , factor vii , tissue factor , gastroenterology , sepsis , hazard ratio , factor viia , confidence interval , coagulation
Summary Background The tissue factor ( TF )‐ Factor VII a ( FVII a) complex has a pivotal role in inflammatory and coagulation responses in patients with systemic inflammatory response syndrome ( SIRS ) and sepsis. Because zymogen FVII ( FVII ) and FVII a compete for binding to TF , their plasma levels determine if a catalytically active TF ‐ FVII a complex will be formed. Objective To study mortality in SIRS patients as a function of FVII a and FVII levels in plasma. Methods This was a cohort study of 275 patients presenting with SIRS , aged 18 years or older and with an anticipated Intensive Care Unit ( ICU ) stay of at least 24 h. FVII a was measured using a novel, quantitative assay that recognizes FVII a, but not FVII . All‐cause hospital mortality was followed over a period of 60 days. Results The percentage of FVII measured as FVII a was higher in non‐survivors than survivors (2.8%, IQR  = 1–5.5% vs. 1.5%, IQR  = 0.6–3.3%; P  = 0.034). High levels of FVII a were associated with decreased 60‐day cumulative survival (62% vs. 81%, P  = 0.030); the opposite was observed for FVII (84% vs. 76%, P  = 0.039). Patients with high‐ FVII a and low‐ FVII levels had a three‐fold increased hazard ratio ( HR ) compared with the patients that had low‐ FVII a and high‐ FVII levels ( HR  = 3.24, 95% confidence interval [ CI ] = 1.41–7.36). This association persisted after adjusting for the APACHE IV score (adjusted HR  = 2.75, 95% CI  = 1.2–6.27). Conclusions SIRS patients with high‐ FVII a and low‐ FVII on admission have an increased mortality risk, an association that is independent from the parameters included in the APACHE IV score.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here