Disseminated intravascular coagulation (DIC) diagnosed based on the Japanese Association for Acute Medicine criteria is a dependent continuum to overt DIC in patients with sepsis
Disseminated intravascular coagulation (DIC) diagnosed based on the Japanese Association for Acute Medicine criteria is a dependent continuum to overt DIC in patients with sepsis
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DOI：
10.1016/j.thromres.2008.07.006
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发表时间：
2009-03-01
影响因子：
7.5
通讯作者：
Shimazaki, Shuji
中科院分区：
文献类型：
--
作者：
Gando, Satoshi;Saitoh, Daizoh;Shimazaki, Shuji
前言：脓毒症是弥散性血管内凝血(DIC)最常见的疾病。为了验证日本急性医学会(JAAM)DIC评分系统(JAAM DIC)诊断的DIC与国际血栓止血协会(ISTH)公开DIC评分系统(ISTH)对脓毒症患者诊断的DIC的相关性，我们进行了一项回顾性研究。材料和方法：对两个前瞻性多中心临床研究的数据库进行分析。纳入标准包括符合Jaam DIC标准的脓毒症相关性DIC患者。结果：本研究纳入166名患者，其中67人符合ISTH临床DIC标准。在第一项研究中，所有在研究期间发展为临床DIC的脓毒症患者都可以通过JaAM DIC诊断标准进行识别。虽然28天的总死亡率为31.3%，但ISTH显性DIC患者的死亡率(40.3%，p=0.0040)和多器官功能障碍综合征(70.1%，p=0.008)的发生率约为Jaam DIC患者的1.5倍。随着JaAM DIC评分的增加，ISTH显性DIC评分和ISTH显性DIC的发生率也逐渐增加。结论：根据JaAM DIC诊断标准诊断的DIC与ISTH显性DIC存在相依的连续体，从而使患者能够得到早期治疗。(C)2008爱思唯尔有限公司。保留所有权利。
Introduction: Sepsis is the most common disease associated with disseminated intravascular coagulation (DIC). To test the hypothesis that DIC diagnosed by the Japanese Association for Acute Medicine (JAAM) DIC scoring system (JAAM DIC) constitutes a dependent continuum to overt DIC diagnosed by the International Society on Thrombosis and Haemostasis (ISTH) overt DIC scoring system (ISTH overt DIC) in patients with sepsis, we conducted a retrospective study.Materials and Methods: The databases from two prospective, multicenter clinical investigations were analyzed. The inclusion criteria comprised patients with sepsis-related DIC, who met the JAAM DIC criteria.Results: The present study enrolled 166 patients, of whom 67 met the ISTH overt DIC criteria. All patients with sepsis who developed to overt DIC during the study period could be identified by the JAAM DIC diagnostic criteria in the first study. While the overall 28-day mortality was 31.3%, mortality (40.3%, p=0.0040) and the incidence of multiple organ dysfunction syndrome (70.1%, p=0.008) of the patients with the ISTH overt DIC was approximately one and a half times that of the patients associated with only the JAAM DIC. A stepwise increase in the ISTH overt DIC scores and the incidence of the ISTH overt DIC were also observed in accordance with the increase in the JAAM DIC scores.Conclusion: DIC diagnosed based on the JAAM DIC diagnostic criteria exists in a dependent continuum to the ISTH overt DIC in patients with sepsis, thus enabling them to receive early treatment. (C) 2008 Elsevier Ltd. All rights reserved.