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Sepsis-induced coagulopathy (SIC) score is an independent predictor of mortality and overt-disseminated intravascular coagulation in emergency department patients with sepsis

  • Gianluca Tullo1
  • Marcello Covino1,2
  • Luigi Carbone3,*,
  • Flavio Lo Dico2
  • Giulia Corsini2
  • Andrea Piccioni1
  • Davide Della Polla1
  • Martina Petrucci1
  • Claudio Sandroni2,4
  • Benedetta Simeoni1
  • Antonio Gasbarrini2,5
  • Francesco Franceschi1,2

1Emergency Department, Fondazione “A. Gemelli Universitary Polyclinic”, IRCCS, 00168 Rome, Italy

2Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy

3Emergency Department, Ospedale Isola Tiberina “Gemelli-Isola”, 00186 Rome, Italy

4Department of Anaesthesiology and Intensive Care Medicine—Fondazione “A. Gemelli Universitary Polyclinic”, IRCCS, 00168 Rome, Italy

5Department of Internal Medicine and Gastroenterology, Fondazione “A. Gemelli Universitary Polyclinic”, IRCCS, 00168 Rome, Italy

DOI: 10.22514/sv.2024.069 Vol.20,Issue 6,June 2024 pp.33-43

Submitted: 15 October 2023 Accepted: 28 November 2023

Published: 08 June 2024

*Corresponding Author(s): Luigi Carbone E-mail:


Sepsis is frequently associated with coagulation anomalies which can contribute to multiple organ dysfunction and death through a mechanism of microvascular thrombosis and possible evolution to consumption coagulopathy. The recently introduced SIC (sepsis-induced coagulopathy) score was developed for the early identification of sepsis-associated coagulopathy. This study aims to evaluate the predictive value of the SIC score for in-hospital mortality and clinically significant complications in emergency department (ED) patients with sepsis. This is a retrospective, observational cohort study including patients with a diagnosis of sepsis admitted to the hospital after an ED evaluation in a period of one year (January 2021 to December 2021). The SIC score was retrospectively calculated from the electronic clinical records of our hospital. The primary outcome was in-hospital mortality; secondary outcomes were coagulopathy-related clinical complications (disseminated intravascular coagulation, bleeding, thrombosis, blood component transfusion, and organ injury). Univariate and multivariate logistic regression analyses were used to assess the association between a positive SIC score and the study endpoints. The study cohort consisted of 357 septic patients. Overall, 82 (23.0%) patients died during hospital stay, and 27 patients (7.6%) developed overt disseminated intravascular coagulation (DIC) At multivariate logistic regression analysis, a positive SIC score at ED admission was an independent predictor of in-hospital mortality, with an Odd Ratio (OR) of 2.28 (95% confidence interval, 1.16–4.48). In addition, the SIC score was an independent predictor for the development of overt-DIC (OR 10.39, (95% CI, 4.08–26.46)), new organ injury (OR 6.33, (95% CI, 2.90–13.83)), bleeding (OR 4.83, (95% CI, 2.22–10.50)) and thrombotic events (OR 9.48, (95% CI, 2.95–30.40)), as well as the need for blood component transfusion (OR 5.28, (95% CI, 2.35–11.83)). In ED patients with sepsis, the SIC score is an early predictor of in-hospital mortality and the development of severe coagulopathy-related complications.


Sepsis; Septic coagulopathy; Disseminated intravascular coagulation; SIC score; Emergency department

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Gianluca Tullo,Marcello Covino,Luigi Carbone,Flavio Lo Dico,Giulia Corsini,Andrea Piccioni,Davide Della Polla,Martina Petrucci,Claudio Sandroni,Benedetta Simeoni,Antonio Gasbarrini,Francesco Franceschi. Sepsis-induced coagulopathy (SIC) score is an independent predictor of mortality and overt-disseminated intravascular coagulation in emergency department patients with sepsis. SignaVitae. 2024. 20(6);33-43.


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