Disseminated Intravascular Coagulopathy Is Associated with the Outcome of Persistent Inflammation, Immunosuppression and Catabolism Syndrome
Disseminated Intravascular Coagulopathy Is Associated with the Outcome of Persistent Inflammation, Immunosuppression and Catabolism Syndrome
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DOI：
10.3390/jcm9082662
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发表时间：
2020-08-01
影响因子：
3.9
通讯作者：
Goto, Tadahiro
中科院分区：
文献类型：
--
作者：
Nakamura, Kensuke;Ogura, Kentaro;Goto, Tadahiro
重症监护后常发生持续性炎症、免疫抑制和卡他卡他综合征（PIICS）。弥漫性血管内凝血（DIC）预计与PIICS的发展独立相关。我们回顾性分析了四年来日立综合医院急诊和重症监护中心收治的5397例患者。在第14天，我们将PIICS分类为C-反应蛋白> 3.0 mg/dL或白蛋白< 3.0 g/dL或淋巴细胞计数< 800/μ L。无PIICS的住院时间延长（>14天）和早期恢复（14天内活着出院）被指定为非PIICS。发现早期死亡（14天内死亡）。我们分析了国际血栓和止血学会公开DIC和PIICS结果之间的关系。结果显示488例PIICS，416例早期死亡和4493例非PIICS病例。分析显示DIC与死亡率、出院时的Barthel指数和PIICS发展显著相关。多变量回归分析和广义结构方程模型将入院时DIC确定为存活患者PIICS的独立危险因素。
Persistent inflammation, immunosuppression and catabolism syndrome (PIICS) often occur after critical care. Disseminated intravascular coagulation (DIC) is expected to be associated independently with PIICS development. We retrospectively analyzed 5397 patients admitted to the Hitachi General Hospital emergency and critical care center during four years. We classified PIICS as C-reactive protein > 3.0 mg/dL or albumin < 3.0 g/dL or lymphocyte count < 800/mu L on day 14. Prolonged hospital stay (>14 days) without PIICS and early recovery (discharged alive within 14 days) were assigned as non-PIICS. Early death (death within 14 days) was identified. We analyzed the association between the International Society on Thrombosis and Haemostasis overt DIC and PIICS outcomes. Results revealed 488 PIICS, 416 early death and 4493 non-PIICS cases. Analyses showed DIC as associated significantly with mortality, the Barthel index at discharge and PIICS development. Multivariate regression analysis and a generalized structural equation model identified DIC on admission as an independent risk factor for PIICS in surviving patients.