|
|||||
|
|
Disseminated intravascular coagulation (DIC) diagnosed based on the Japanese Association for Acute Medicine criteria is a dependent continuum to overt DIC in patients with sepsis |
|
| Authors: | Gando Satoshi,Saitoh Daizoh,Ogura Hiroshi,Mayumi Toshihiko,Koseki Kazuhide,Ikeda Toshiaki,Ishikura Hiroyasu,Iba Toshiaki,Ueyama Masashi,Eguchi Yutaka,Otomo Yasuhiro,Okamoto Kohji,Kushimoto Shigeki,Endo Shigeatsu,Shimazaki Shuji Japanese Association for Acute Medicine Disseminated Intravascular Coagulation Study Group |
| Affiliation: | a Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, N17 W5, Kita-ku, Sapporo 060-8638 Japan b Division of Traumatology, National Defense Medical College Research Institute, National Defense Medical College, Japan c Department of Traumatology and Acute Critical Care Medicine, Osaka University Medical School, Japan d Department of Emergency and Critical Care Medicine, Nagoya University Graduate School of Medicine, Japan e Emergency and Critical Care Medicine, Kawaguchi Municipal Medical Center, Japan f Department of Critical Care and Emergency Medicine, Tokyo Medical University Hachioji Medical Center, Japan g Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, Japan h Department of Emergency Medicine, Juntendo University, Japan i Department of Traumatology, Critical Care Medicine and Burn Center, Social Insurance Chukyo Hospital, Japan j Critical and Intensive Care Medicine, Shiga University of Medical Science, Japan k Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Graduate School of Medicine, Japan l Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Japan m Department of Emergency and Critical Care Medicine, Nippon Medical School, Japan n Department of Critical Care Medicine, School of Medicine, Iwate Medical University, Japan o Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Japan |
| Abstract: | IntroductionSepsis is the most common disease associated with disseminated intravascular coagulation (DIC). To test the hypothesis that DIC diagnosed by the Japanese Association for Acute Medicine (JAAM) DIC scoring system (JAAM DIC) constitutes a dependent continuum to overt DIC diagnosed by the International Society on Thrombosis and Haemostasis (ISTH) overt DIC scoring system (ISTH overt DIC) in patients with sepsis, we conducted a retrospective study.Materials and MethodsThe databases from two prospective, multicenter clinical investigations were analyzed. The inclusion criteria comprised patients with sepsis-related DIC, who met the JAAM DIC criteria.ResultsThe present study enrolled 166 patients, of whom 67 met the ISTH overt DIC criteria. All patients with sepsis who developed to overt DIC during the study period could be identified by the JAAM DIC diagnostic criteria in the first study. While the overall 28-day mortality was 31.3%, mortality (40.3%, p = 0.0040) and the incidence of multiple organ dysfunction syndrome (70.1%, p = 0.008) of the patients with the ISTH overt DIC was approximately one and a half times that of the patients associated with only the JAAM DIC. A stepwise increase in the ISTH overt DIC scores and the incidence of the ISTH overt DIC were also observed in accordance with the increase in the JAAM DIC scores.ConclusionDIC diagnosed based on the JAAM DIC diagnostic criteria exists in a dependent continuum to the ISTH overt DIC in patients with sepsis, thus enabling them to receive early treatment. |
| Keywords: | APACHE II, Acute Physiology and Chronic Health Evaluation II DIC, disseminated intravascular coagulation FDP, fibrin/fibrinogen degradation products ISTH, International Society on Thrombosis and Haemostasis JAAM, Japanese Association for Acute Medicine MODS, multiple organ dysfunction syndrome SIRS, systemic inflammatory response syndrome SOFA, Sequential Organ Failure Assessment. |
| 本文献已被 ScienceDirect PubMed 等数据库收录！ | |