Clinical study of disseminated intravascular coagulation in oral and maxillofacial regions--predictors of onset and prognosis.
OBJECTIVE
To examine disseminated intravascular coagulation (DIC) cases in detail to identify the predictors of onset and prognosis.


METHODS
The clinical records of eight patients with DIC were examined with regard to the patient's background, underlying disease, direct inducers, duration, contents of treatments and outcome. The factors which controlled the onset and prognosis of DIC were examined in cases receiving surgery for malignant neoplasm compared with non-DIC cases. Wilcoxon test was used for statistical analysis.


RESULTS
There were seven males and one female, age range from 25 to 93 years. The underlying diseases were six malignant neoplasms, one severe infection, and one case of multiple injuries of the mandible. Seven patients had pretherapeutic complications, and six patients recovered. Reduction in platelet counts immediately after the operation revealed high values up to 36%, and patients with more than two pretherapeutic complications were more susceptible to DIC when major postoperative complications occurred. The operation time and blood loss may also have affected the outcome.


CONCLUSIONS
Change of platelet counts, number of pretherapeutic complications, operation time and blood loss are important for predicting the onset and prognosis of DIC in the oral and maxillofacial regions.
Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Japan. ysn-mori@nmu-gw.naramed-u.ac.jp
Y
Y
Morimoto
M
M
Ikeuchi
K
K
Yamamoto
T
T
Kirita
M
M
Sugimura
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical; D004211:Disseminated Intravascular Coagulation / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D005491:Focal Infection, Dental / Q000150:complications; D006801:Humans; D008297:Male; D008338:Mandibular Injuries / Q000150:complications; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000150:complications*; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D010976:Platelet Count; D011379:Prognosis; D012307:Risk Factors