Abstract Number: PB1858
Meeting: ISTH 2020 Congress
Background: Despite a better knowledge of A Disintegrin and Metalloprotease with Thrombospondin Motif 13 (ADAMTS13), there is still a paucity of data regarding the prognostic value of ADAMTS13 in severe sepsis and septic shock.
Aims: ADAMTS13 level was evaluated as a predictor of mortality in patients with severe sepsis and septic shock, and compared with Acute Physiology and Chronic Health Evaluation II (APACHE II) scores.
Methods: This prospective observational study was conducted in the Medical and Surgical Intensive Care Units of King Saud University Medical City, King Saud University, Riyadh. A total of 84 patients aged 56.08±18.18 years with severe sepsis and septic shock were recruited. Serial ADAMTS13 levels were determined at 24 intervals and APACHE II scores, hematological profiles, indices of organ hypo-perfusion, renal functions and coagulation profiles were recorded. Primary outcome was 30 days ICU mortality and secondary outcomes were its comparison with APACHE II score, length of ICU stay and use of vasopressor agents.
Results: The median ADAMTS13 levels were 336.65, 339.35 and 313.9, respectively. ROC analysis showed maximum area under the curve for second ADAMTS13 (AUC=0.760) compared with first (AUC=0.660) and third samples (AUC=0.707) and APACHE II scores (AUC=0.662). Hypertension (53.6%) and diabetic mellitus (45.2%) were the commonest comorbidities. Patients were divided into low and high ADAMTS13 groups according to the best cut-off point. Mortality was high in the low ADAMTS13 level group [≤365 ng/ml, OR=4.5] and was significantly associated with age, diastolic blood pressure, ADAMTS13, APACHE II score, DIC score and platelet count. ADAMTS13 (OR=5.3), APACHE II (OR=4.13) and DIC scores (OR=7.32) were significant risk factors for mortality in multivariate stepwise logistic regression model.
Conclusions: Low ADAMTS13 levels are associated with increased mortality in patients with severe sepsis and septic shock and are comparable to APACHE II scores for predicting mortality.
To cite this abstract in AMA style:Habib S, Azfar MF, Al Aseri Z. Prognostic Value of A Disintegrin and Metalloprotease with Thrombospondin Motif 13 in Patients with Severe Sepsis and Septic Shock [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/prognostic-value-of-a-disintegrin-and-metalloprotease-with-thrombospondin-motif-13-in-patients-with-severe-sepsis-and-septic-shock/. Accessed September 21, 2023.
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