Disseminated intravascular coagulation. Findings in 346 patients.
An analysis was made of 346 cases of disseminated intravascular coagulation (DIC) diagnosed by utilizing a combination of laboratory tests which reflect the pathophysiology of the syndrome. The goals of the study were three fold: 1) to compare our clinical disease categories with those of other investigators, 2) to re-evaluate the diagnostic tests and, 3) most importantly, to report the results of tests infrequently performed when evaluating DIC. The patients fell into the following groups: 1) infection -- 26%, 2) malignancy -- 24%, 3) surgery and trauma -- 19%, 4) liver disease -- 8%, 5) miscellaneous -- 23%. Of the diagnostic tests, those for fibrin split products (FSP), fibrin monomer and antithrombin III were the most valuable. Of the clotting proteins, factors II, V, VII and X were the most frequently decreased. The factor VIII: C levels were in conflict with the prevailing dogma. Factor VIII:C levels were decreased in only 9% of patients studied and, in fact, were increased in the majority of cases. Factor VIIIR:Ag and F VIIIR:vW were elevated in 80% of the patients evaluated. An overall mortality of 68% further confirms the dismal prognosis previously associated with DIC.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D001760:Bleeding Time; D001780:Blood Coagulation Tests; D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation / Q000503:physiopathology*; D000431:Ethanol / Q000097:blood; D005165:Factor V / Q000032:analysis; D005167:Factor VII / Q000032:analysis; D005169:Factor VIII / Q000032:analysis; D005170:Factor X / Q000032:analysis; D005260:Female; D005782:Gels; D006331:Heart Diseases / Q000601:surgery; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000097:blood; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood; D010976:Platelet Count; D011516:Prothrombin / Q000032:analysis
D005782:Gels; D000431:Ethanol; D000990:Antithrombin III; D005165:Factor V; D005167:Factor VII; D011516:Prothrombin; D005169:Factor VIII; D005170:Factor X; D006493:Heparin