Performance Evaluation of Five Different Disseminated Intravascular Coagulation (DIC) Diagnostic Criteria for Predicting Mortality in Patients with Complicated Sepsis.
10.3346/jkms.2016.31.11.1838
- Author:
Sang Ook HA
1
;
Sang Hyuk PARK
;
Sang Bum HONG
;
Seongsoo JANG
Author Information
1. Department of Emergency Medicine, Hallym University Medical Center, Hallym University Sacred Heart Hospital, Anyang, Korea.
- Publication Type:Original Article
- Keywords:
Criteria;
Diagnosis;
Disseminated Intravascular Coagulation;
Mortality;
Sepsis
- MeSH:
Asian Continental Ancestry Group;
Dacarbazine;
Diagnosis;
Disseminated Intravascular Coagulation*;
Hemostasis;
Humans;
Intensive Care Units;
Mortality*;
Prognosis;
Sepsis*;
Shock, Septic;
Thrombosis
- From:Journal of Korean Medical Science
2016;31(11):1838-1845
- CountryRepublic of Korea
- Language:English
-
Abstract:
Disseminated intravascular coagulation (DIC) is a major complication in sepsis patients. We compared the performance of five DIC diagnostic criteria, focusing on the prediction of mortality. One hundred patients with severe sepsis or septic shock admitted to intensive care unit (ICU) were enrolled. Routine DIC laboratory tests were performed over the first 4 days after admission. The overall ICU and 28-day mortality in DIC patients diagnosed from five criteria (International Society on Thrombosis and Haemostasis [ISTH], the Japanese Association for Acute Medicine [JAAM], the revised JAAM [R-JAAM], the Japanese Ministry of Health and Welfare [JMHW] and the Korean Society on Thrombosis and Hemostasis [KSTH]) were compared. Both KSTH and JMHW criteria showed superior performance than ISTH, JAAM and R-JAAM criteria in the prediction of overall ICU mortality in DIC patients (odds ratio 3.828 and 5.181, P = 0.018 and 0.006, 95% confidence interval 1.256–11.667 and 1.622–16.554, respectively) when applied at day 1 after admission, and survival analysis demonstrated significant prognostic impact of KSTH and JMHW criteria on the prediction of 28-day mortality (P = 0.007 and 0.049, respectively) when applied at day 1 after admission. In conclusion, both KSTH and JMHW criteria would be more useful than other three criteria in predicting prognosis in DIC patients with severe sepsis or septic shock.
