title: Performance Evaluation of Five Different Disseminated Intravascular Coagulation (DIC) Diagnostic Criteria for Predicting Mortality in Patients with Complicated Sepsis.
abstract: Disseminated intravascular coagulation (DIC) is a major complication in sepsis patients. We compared the performance of five DIC diagnostic criteria, focusing on the prediction of mortality. One hundred patients with severe sepsis or septic shock admitted to intensive care unit (ICU) were enrolled. Routine DIC laboratory tests were performed over the first 4 days after admission. The overall ICU and 28-day mortality in DIC patients diagnosed from five criteria (International Society on Thrombosis and Haemostasis [ISTH], the Japanese Association for Acute Medicine [JAAM], the revised JAAM [R-JAAM], the Japanese Ministry of Health and Welfare [JMHW] and the Korean Society on Thrombosis and Hemostasis [KSTH]) were compared. Both KSTH and JMHW criteria showed superior performance than ISTH, JAAM and R-JAAM criteria in the prediction of overall ICU mortality in DIC patients (odds ratio 3.828 and 5.181, P = 0.018 and 0.006, 95% confidence interval 1.256-11.667 and 1.622-16.554, respectively) when applied at day 1 after admission, and survival analysis demonstrated significant prognostic impact of KSTH and JMHW criteria on the prediction of 28-day mortality (P = 0.007 and 0.049, respectively) when applied at day 1 after admission. In conclusion, both KSTH and JMHW criteria would be more useful than other three criteria in predicting prognosis in DIC patients with severe sepsis or septic shock.
authors.affiliation: Department of Emergency Medicine, Hallym University Medical Center, Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Sang Ook
authors.identifier: http://orcid.org/0000-0002-2651-1023
authors.initials: SO
authors.lastname: Ha
authors.affiliation: Department of Laboratory Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.|Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
authors.forename: Sang Hyuk
authors.identifier: http://orcid.org/0000-0001-7284-6273
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
authors.forename: Sang Bum
authors.identifier: http://orcid.org/0000-0003-2737-7695
authors.initials: SB
authors.lastname: Hong
authors.affiliation: Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea. ssjang@amc.seoul.kr.
authors.forename: Seongsoo
authors.identifier: http://orcid.org/0000-0002-0045-1747
authors.initials: S
authors.lastname: Jang
mesh_terms: D000368:Aged; D019540:Area Under Curve; D001792:Blood Platelets / Q000166:cytology; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011446:Prospective Studies; D011517:Prothrombin Time; D012372:ROC Curve; D018805:Sepsis / Q000150:complications* / Q000401:mortality; D012720:Severity of Illness Index; D016019:Survival Analysis; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications
chemical_list: D005340:Fibrinogen
keywords: Criteria; Diagnosis; Disseminated Intravascular Coagulation; Mortality; Sepsis