Abstract
Summary An ancillary analysis to the SepsiCoag multicentric prospective observational study on patients entering an intensive care unit with septic shock evaluated the prognostic potential of fibrin generation markers ( FGM s) tested at inclusion in the study, on survival at day 30. After centralization of samples, three automated FGM s were compared: D‐dimers (DDi), fibrin/fibrinogen degradation products ( FDP ) and fibrin monomers ( FM ). FM was the single FGM that was significantly higher in non‐surviving patients, area under the receiver‐operator characteristic curve (AUC ROC ): 0·617, P < 0·0001. Significantly higher International Society on Thrombosis and Haemostasis Disseminated Intravascular Coagulation ( ISTH DIC ) scores were calculated in non‐survivors using each of the three FGM s. A dose‐effect relationship was observed between ISTH DIC scores and non‐survival, with highest significance obtained using FM as the FGM . An overt DIC diagnosis using the ISTH DIC score calculated using FM was a predictor of non‐survival at day 30, independently from overt DIC diagnosis based on scores calculated using FDP or DDi . The AUC ROC values testing the ability of the ISTH DIC score to predict non‐survival were 0·650, 0·624 and 0·602 using FM , DDi and FDP , respectively, as the FGM . In patients with septic shock, among the commercially‐available automated assays, automated FM is the FGM best related with late prognosis.