{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:26:33Z","timestamp":1777350393753,"version":"3.51.4"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100024416","name":"Institute of Health, Jimma University","doi-asserted-by":"publisher","award":["Mega Research Fund Scheme (2022-2025)"],"award-info":[{"award-number":["Mega Research Fund Scheme (2022-2025)"]}],"id":[{"id":"10.13039\/501100024416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\nBackground<\/jats:title>\nDespite the established link between sepsis and disseminated intravascular coagulation (DIC), data on the prevalence of DIC, associated factors and patient outcomes in sepsis patients are inadequate in resource-limited settings. Therefore, the present study aimed to determine the magnitude of DIC and associated factors and mortality and predictors in septic adults admitted to intensive care units (ICUs).<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nA prospective longitudinal study involving adults admitted to intensive care units was conducted. A structured checklist and questionnaire were used to collect patient demographic and clinical data. Blood samples were collected on days 1, 3, and 5 of admission for all laboratory analyses. A DIC diagnosis was made on the basis of the Japanese Association for Acute Medicine (JAAM) score. Descriptive statistics, multivariable logistic regression analysis, receiver operating characteristic (ROC) curve analysis and Kaplan\u2012Meier survival analysis were employed in this study.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nThe overall prevalence of DIC in sepsis patients was 38 (25.7%). There were 24 (16.2%) patients who developed DIC on day 1 of admission, while 20 (19.4%) and 9 (12.9%) patients developed DIC on day 3 and day 5 of admission, respectively. Increased aspartate transaminase (AST) (AOR: 4.39; 95% CI: 1.75\u201311.01), thrombocytopenia (AOR: 6.04; 95% CI: 2.41\u201315.12), and prolonged prothrombin time (PT) (AOR: 3.40; 95% CI: 1.36\u20138.51) were independent predictors of DIC in sepsis patients. There was no statistically significant difference in survival between patients with and without DIC (p\u2009<\u20090.328). The JAAM score at ICU admission predicted ICU mortality (AUC: 0.787; 95% CI: 0.624\u20130.950).<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nA quarter of ICU-admitted septic adults developed DIC. The incidence was notably greater by the third day after admission, highlighting the importance of closely monitoring these patients for DIC progression. Elevated AST liver enzyme levels, thrombocytopenia, and prolonged PT are linked to the development of DIC. Changes in these variables could prompt further examination for DIC. The mortality rate did not significantly differ between septic patients with and without DIC. The JAAM score used to diagnose DIC in sepsis patients can serve as a predictor of ICU mortality in sepsis patients with DIC.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330842","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T17:37:58Z","timestamp":1755884278000},"page":"e0330842","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Disseminated intravascular coagulation, associated factors and clinical outcomes among critically Ill septic adults admitted to a tertiary hospital in Ethiopia: A prospective longitudinal study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7858-3793","authenticated-orcid":true,"given":"Girum Tesfaye","family":"Kiya","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeleke","family":"Mekonnen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elsah Tegene","family":"Asefa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gedion","family":"Milkias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edosa","family":"Tadasa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edosa","family":"Kejela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iyasu","family":"Demeke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aragaw","family":"Fiseha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7172-9136","authenticated-orcid":true,"given":"Gemeda","family":"Abebe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"pone.0330842.ref001","doi-asserted-by":"crossref","DOI":"10.1177\/1076029618806424","article-title":"Disseminated Intravascular Coagulation: An Update on Pathogenesis, Diagnosis, and Therapeutic Strategies","volume":"24","author":"C Papageorgiou","year":"2018","journal-title":"Clinical and Applied Thrombosis\/Hemostasis"},{"issue":"5","key":"pone.0330842.ref002","first-page":"1327","article-title":"Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation","volume":"86","author":"Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH).","year":"2001","journal-title":"Thromb Haemost"},{"issue":"8","key":"pone.0330842.ref003","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1182\/blood-2017-10-804096","article-title":"How I treat disseminated intravascular coagulation","volume":"131","author":"M Levi","year":"2018","journal-title":"Blood"},{"issue":"2","key":"pone.0330842.ref004","first-page":"196","article-title":"Disseminated intravascular coagulation","volume":"53","author":"H Wada","year":"2012","journal-title":"Rinsho Ketsueki"},{"issue":"3","key":"pone.0330842.ref005","doi-asserted-by":"crossref","DOI":"10.1186\/cc12783","article-title":"A multicenter, prospective validation study of the Japanese Association for Acute Medicine disseminated intravascular coagulation scoring system in patients with severe sepsis","volume":"17","author":"S Gando","year":"2013","journal-title":"Crit Care"},{"key":"pone.0330842.ref006","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.thromres.2019.04.025","article-title":"Role of disseminated intravascular coagulation in severe sepsis","volume":"178","author":"S Gando","year":"2019","journal-title":"Thromb Res"},{"issue":"4","key":"pone.0330842.ref007","doi-asserted-by":"crossref","first-page":"334","DOI":"10.4266\/kjccm.2016.00339","article-title":"The Prevalence and Significance of Overt Disseminated Intravascular Coagulation in Patients with Septic Shock in the Emergency Department According to the Third International Consensus Definition","volume":"31","author":"BS Ko","year":"2016","journal-title":"Korean J Crit Care Med"},{"key":"pone.0330842.ref008","doi-asserted-by":"crossref","unstructured":"Solanki D, Lal D, Sunny A, Han X, Iyanar S, Halder A. 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