Frequency and hemostatic abnormalities in pre-DIC patients.
Disseminated intravascular coagulation (DIC) sometimes has a poor outcome, and therefore early diagnosis and treatment are required. This study prospectively evaluated the hemostatic abnormalities and the onset of DIC in 613 patients with underlying diseases to identify a useful marker for diagnosing Pre-DIC. Pre-DIC was defined as the condition of patients within a week before the onset of DIC. Initially, 34.4% of patients were diagnosed with DIC, and about 8.5% of the patients without DIC were diagnosed as DIC within a week after registration (pre-DIC). The mortality of DIC, Pre-DIC and "without DIC" was 35.3%, 32.4% and 17.2%, respectively. All hemostatic parameters were significantly worse in "DIC" than "without DIC" and the values of the prothrombin time ratio, platelet count and fibrin monomer complex could classify the three groups; "DIC", "pre-DIC" and "without DIC". No useful marker was identified that provided an adequate cutoff value to differentiate "pre-DIC" from "without DIC". A multivariate analysis identified clinical symptoms that were related to poor outcome. DIC must be treated immediately; there is no specific marker to identify pre-DIC.
Okamoto
Kohji
K
First Department of Surgery, University of Occupational and Environmental Health School of Medicine, KitaKyushu, Japan.
Wada
Hideo
H
Hatada
Tsuyoshi
T
Uchiyama
Toshimasa
T
Kawasugi
Kazuo
K
Mayumi
Toshihiko
T
Gando
Satoshi
S
Kushimoto
Shigeki
S
Seki
Yoshinobu
Y
Madoiwa
Seiji
S
Asakura
Hidesaku
H
Koga
Shin
S
Iba
Toshiaki
T
Maruyama
Ikuro
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D006487:Hemostasis / Q000502:physiology*; D006490:Hemostatics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010976:Platelet Count; D011446:Prospective Studies
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D006490:Hemostatics; C011468:fibrinmonomer