title: A prospective analysis of disseminated intravascular coagulation in patients with infections.
abstract: OBJECTIVE
  Disseminated intravascular coagulation (DIC) is often associated with infection and a poor outcome. In this study, useful markers for predicting poor outcomes were examined.
  
  
  METHODS
  The frequency of DIC and organ failure, outcomes and hemostatic markers were prospectively evaluated in 242 patients with infections.
  
  
  RESULTS
  Seventy-seven patients were diagnosed with DIC, 36 of whom recovered from the condition. The rate of DIC or resolution of DIC was highest in the patients with sepsis and lowest in the patients with respiratory infections. Mortality tended to be high in the patients with respiratory infections. The DIC score, sepsis-related organ failure assessment (SOFA) score, prothrombin time (PT) ratio and thrombin-antithrombin complex level were significantly high in the patients who did not recover from DIC. The age, DIC score, SOFA score, PT ratio and levels of thrombomodulin and plasminogen activator inhibitor (PAI)-I were significantly high in the non-survivors. Factors related to a poor outcome included resolution of DIC, the SOFA score, age and the PT ratio. Factors related to resolution of DIC included the SOFA score and age, while factors related to the SOFA score included the levels of PAI-I, leukocytes, fibrinogen, D-dimer and platelets.
  
  
  CONCLUSIONS
  The outcomes of septic patients primarily depend on the SOFA score and the resolution of DIC, which are related to organ failure.
authors.affiliation: Department of Internal Medicine, Shibata Hospital-Niigata Prefectural Hospital, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Seki
authors.forename: Hideo
authors.initials: H
authors.lastname: Wada
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kawasugi
authors.forename: Kohji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kushimoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hatada
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imai
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D018805:Sepsis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D018180:Thrombomodulin / Q000097:blood
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; C546931:THBD protein, human; D018180:Thrombomodulin