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2016 ; 31
(11
): 1838-1845
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Performance Evaluation of Five Different Disseminated Intravascular Coagulation
(DIC) Diagnostic Criteria for Predicting Mortality in Patients with Complicated
Sepsis
#MMPMID27709865
Ha SO
; Park SH
; Hong SB
; Jang S
J Korean Med Sci
2016[Nov]; 31
(11
): 1838-1845
PMID27709865
show ga
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.