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Chokri Ben Lamine: Sepsis Induced Coagulopathy Is Not a Single Disease Phenotype
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May 11, 2026, 15:19

Chokri Ben Lamine: Sepsis Induced Coagulopathy Is Not a Single Disease Phenotype

Chokri Ben Lamine, Assistant Consultant at King Faisal Specialist Hospital and Research Center, shared a post on X about a recent article by Lu Wang et al., published in Thrombosis Journal:

“Sepsis-Induced Coagulopathy (SIC) is NOT one disease phenotype – major heterogeneity exists between INR-dominant vs platelet-dominant SIC.

Credits for sharing:

  • Dr Ruaa Alyamany
  • KFSHRC.

Key findings from Wang and Zhou, Thrombosis Journal 2026:

SIC incidence in sepsis reached 48.7%.

SIC-INR phenotype:

  • Higher bilirubin
  • Higher ALT
  • More liver dysfunction
  • More CRRT support
  • Longer mechanical ventilation
  • Longer hospital stay.

SIC-PLT phenotype:

  • Lower fibrinogen
  • Shorter APTT
  • Lower lactate
  • Lower glucose
  • Less hepatic/renal dysfunction
  • Shorter ventilation duration.

Pulmonary infection was the most common source of SIC (approximately 47%)․

DVT positivity in SIC reached approximately 22.9%․

SIC-INR had significantly higher DVT rates vs SIC-PLT․

  • SIC-INR: 29.9%
  • SIC-PLT: 19.1%․

Important concept:

Two patients may both fulfill SIC criteria but represent biologically different phenotypes with different organ dysfunction patterns and outcomes.

  • SIC-PLT phenotype appears more hematopoietic/consumptive
  • SIC-INR phenotype appears more hepatopathic/metabolic.

INR elevation in sepsis may reflect:

  • Hepatic synthetic dysfunction
  • Drug interactions
  • Vitamin K alterations
  • Severe inflammatory response.

Platelet-dominant SIC may reflect:

  • Bone marrow suppression
  • Platelet consumption
  • Early consumptive coagulopathy.

Clinical implication:

  • Future SIC trials and anticoagulation strategies should stratify by phenotype instead of treating SIC as a monolithic entity.

Another key pearl:

  • Overall SOFA differences disappeared after excluding coagulation components → supporting true coagulation phenotype heterogeneity.

Mortality:

  • No significant mortality difference in PUMCH cohort
  • But lower mortality in SIC-PLT phenotype in MIMIC-IV validation cohort.

Intermuscular vein thrombosis was the most common DVT subtype in SIC patients.”

Title: Sepsis induced coagulopathy (SIC): is it monolithic?

Authors: Lu Wang, Xiang Zhou

Chokri Ben Lamine: Sepsis Induced Coagulopathy Is Not a Single Disease Phenotype

Other posts featuring Chokri Ben Lamine on Hemostasis Today.

bleeding disorders Chokri Ben Lamine Health Hematology Hemostasis Hemostasis News Hemostasis Today Lu Wang Medicine Sepsis Sepsis Induced Coagulopathy SIC Thrombosis Journal Xiang Zhou
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