ABSTRACT
This study enrolled 20 patients who had been hospitalized for SIRS as well as 20 age and sex matched subjects served as control group. All patients and control groups were subjected to full clinical evaluation with application of APACHE II scoring, routine laboratory investigations as well as specific investigations; namely, plasma levels of protein C, D-dimer [DD], antithrombin III [ATIII] and thrombin- antithrombin complex [TAT] upon admission, 48 and 96 hours later and on discharge in survivors. The study showed that activated protein C level was consumed significantly in patients with SIRS compared to control subjects. As comparing its levels in survivors and non survivors, the former showed persistent rise of the level to normal values in contrast to the latter in which their levels were persistently low [34.8 +/- 26% vs 40.6 +/- 22% on admission and 82 +/- 13% vs 41 +/- 21% after 144 hrs, respectively]. Patients with septic shock also showed significantly lower levels of APC compared to those without shock [28.8 +/- 12% vs 56.8 +/- 28% on admission and 41.7 +/- 21.8% vs 82 +/- 13% after 144 hrs, respectively]. APC levels also were lower in patients with multiorgan failure syndrome [MODS] as compared to those without MODS [40.8 +/- 27.8% vs 116 +/- 29, respectively] with statistically insignificant lower level in patients with APACHE > 20 as compared to those with APACHE < 20 [35.2 +/- 22 vs 45 +/- 24%, P: NS]. The other coagulopathy markers of sepsis DD, AT III, TAT complex did not show any significant difference between survivors and non-survivors [2 +/- 3.6 vs 4.9 +/- 8 ng/ml for DD, 40.75 +/- 17.6% vs 40 +/- 15.7% for AT III and 24.7 +/- 25 vs 22 +/- 19 ug/ml for TAT, P: NS, respectively]