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Usefulness of the Thrombotic Microangiopathy Score as a Promising Prognostic Marker of Septic Shock for Patients in the Emergency Department

 Dong Ryul Ko  ;  Taeyoung Kong  ;  Hye Sun Lee  ;  Sinae Kim  ;  Jong Wook Lee  ;  Hyun Soo Chung  ;  Sung Phil Chung  ;  Je Sung You  ;  Jong Woo Park 
 Journal of Clinical Medicine, Vol.8(6) : E808, 2019 
Journal Title
 Journal of Clinical Medicine 
Issue Date
mortality ; predictor ; sepsis ; thrombotic microangiopathy score
The thrombotic microangiopathy (TMA) score based on the development and morphological characteristics of schistocytes is a rapid, simple biomarker that is easily obtained from the complete blood cell count by an automated blood cell analyzer. We aimed to determine whether the TMA score is associated with 30-day mortality of patients with early-stage septic shock. This observational cohort study was retrospectively conducted based on a prospective emergency department (ED) registry (June 2015-December 2016). We analyzed the TMA score at ED admission and 24 h later. The primary endpoint was all-cause mortality within 30 days of ED admission. A total of 221 patients were included. Increased TMA scores at time 0 (odds ratio (OR), 1.972; 95% confidence interval (CI), 1.253-3.106; p = 0.003) and at time 24 (OR, 1.863; 95% CI, 1.863-3.066; p = 0.014) were strong predictors of 30-day mortality. Increased predictability of 30-day mortality was closely associated with TMA scores ≥2 at time 0 (OR, 4.035; 95% CI, 1.651-9.863; p = 0.002) and ≥3 at time 24 (OR, 5.639; 95% CI, 2.190-14.519; p < 0.001). Increased TMA scores significantly predicted 30-day mortality for patients with severe sepsis and septic shock and can be helpful when determining the initial treatment strategies without additional costs or effort.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Ko, Dong Ryul(고동률) ORCID logo https://orcid.org/0000-0002-3098-2784
Kong, Tae Young(공태영) ORCID logo https://orcid.org/0000-0002-4182-7245
Kim, Si Nae(김시내)
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Chung, Hyun Soo(정현수) ORCID logo https://orcid.org/0000-0001-6110-1495
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