Comparison of five different disseminated intravascular coagulation criteria in predicting mortality in patients with sepsis

被引:0
作者
Zafar, Amara [1 ]
Naeem, Filza [1 ]
Khalid, Muhammad Zain [1 ]
Awan, Safia [1 ]
Riaz, Muhammad Mehmood [1 ]
Mahmood, Saad Bin Zafar [1 ]
机构
[1] Aga Khan Univ Hosp, Dept Med, Karachi, Pakistan
来源
PLOS ONE | 2024年 / 19卷 / 03期
关键词
DIAGNOSTIC-CRITERIA; MULTICENTER; VALIDATION;
D O I
10.1371/journal.pone.0295050
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objective Even though patients with sepsis and DIC have a higher mortality rate compared to those without DIC, screening for DIC is not currently part of sepsis management protocols. This may be due to a lack of literature on the frequency of DIC occurrence in sepsis patients, as well as the absence of evidence on the optimal DIC criteria to use for identifying DIC and predicting mortality among the five criteria available. To address this gap, this study investigates the predictive value of five different criteria for diagnosing DIC and its relationship to patient outcomes in our population of sepsis patients.Methods In the Medicine department of Aga Khan University Hospital, a retrospective observational study was conducted, enrolling all adult patients with International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) coding of sepsis and clinical suspicion of DIC between January 2018 and December 2020. To diagnose DIC, five different criteria were utilized, namely the International Society of Thrombosis and Hemostasis (ISTH), the Korean Society on Thrombosis and Hemostasis (KSTH), the Japanese Association for Acute Medicine (JAAM), the revised-JAAM (RJAAM), and the Japanese Ministry of Health and Welfare (JMHW). The study analyzed the sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of these five criteria, as well as the overall prediction of mortality.Results Of 222 septic patients included in this study with clinical suspicion of DIC, 94.6% of patient had DIC according to KSTH criteria, followed by JAAM (69.4%), ISTH (64.0%), JMHW (53.2%) and lastly R-JAAM (48.6%). KSTH had sensitivity of 95.4% in diagnosing DIC and predicting mortality with a positive predictive value of 70% but specificity of 7.3% only. JAAM had sensitivity of 75.9%, positive predictive value of 75.9% with a specificity of 45.5%. ISTH had sensitivity of 69.4%, positive predictive value 75.3% and specificity of 48.5%.Conclusion DIC can impose a significant burden on septic patients and its presence can lead to higher mortality rates. Early detection through screening for DIC in septic patients can potentially reduce mortality. However, it is necessary to identify the most appropriate diagnostic criteria for each population, as various criteria have demonstrated different performance in different populations. Establishing a gold standard for each population can aid in accurate diagnosis of DIC.
引用
收藏
页数:11
相关论文
共 17 条
  • [1] Disseminated intravascular coagulation: epidemiology, biomarkers, and management
    Adelborg, Kasper
    Larsen, Julie B.
    Hvas, Anne-Mette
    [J]. BRITISH JOURNAL OF HAEMATOLOGY, 2021, 192 (05) : 803 - 818
  • [2] [Anonymous], 2015, Clinical Infectious Diseases, V60, P88
  • [3] Use of explicit ICD9-CM codes to identify adult severe sepsis: impacts on epidemiological estimates
    Bouza, C.
    Lopez-Cuadrado, T.
    Amate-Blanco, J. M.
    [J]. CRITICAL CARE, 2016, 20
  • [4] A multicenter, prospective validation of disseminated intravascular coagulation diagnostic criteria for critically ill patients: Comparing current criteria
    Gando, S
    Iba, T
    Eguchi, Y
    Ohtomo, Y
    Okamoto, K
    Koseki, K
    Mayumi, T
    Murata, A
    Ikeda, T
    Ishikura, H
    Ueyama, M
    Ogura, H
    Kushimoto, S
    Saitoh, D
    Endo, S
    Shimazaki, S
    [J]. CRITICAL CARE MEDICINE, 2006, 34 (03) : 625 - 631
  • [5] Role of disseminated intravascular coagulation in severe sepsis
    Gando, Satoshi
    Shiraishi, Atsushi
    Yamakawaka, Kazuma
    Ogura, Hiroshi
    Saitoh, Daizoh
    Fujishima, Seitaro
    Mayumi, Toshihiko
    Kushimoto, Shigeki
    Abe, Toshikazu
    Shiino, Yasukazu
    Nakada, Taka-aki
    Tarui, Takehiko
    Hifumi, Toru
    Otomo, Yasuhiro
    Okamoto, Kohji
    Umemura, Yutaka
    Kotani, Joji
    Sakamoto, Yuichiro
    Sasaki, Junichi
    Shiraishi, Shin-ichiro
    Takuma, Kiyotsugu
    Tsuruta, Ryosuke
    Hagiwara, Akiyoshi
    Masuno, Tomohiko
    Takeyama, Naoshi
    Yamashita, Norio
    Ikeda, Hiroto
    Ueyama, Masashi
    Fujimi, Satoshi
    Tasaki, Osamu
    Mizobata, Yasumitsu
    Funakoshi, Hiraku
    Okuyama, Toshiro
    Yamashita, Iwao
    Kanai, Toshio
    Yamada, Yasuo
    Aibiki, Mayuki
    Sato, Keiji
    Yamashita, Susumu
    Yoshida, Kenichi
    Kasaoka, Shunji
    Kon, Akihide
    Rinka, Hiroshi
    Kato, Hiroshi
    Okudera, Hiroshi
    Narimatsu, Eichi
    Fujiwara, Toshifumi
    Sugita, Manabu
    Shichinohe, Yasuo
    Nakae, Hajime
    [J]. THROMBOSIS RESEARCH, 2019, 178 : 182 - 188
  • [6] Disseminated intravascular coagulation
    Gando, Satoshi
    Levi, Marcel
    Toh, Cheng-Hock
    [J]. NATURE REVIEWS DISEASE PRIMERS, 2016, 2
  • [7] A multicenter, prospective validation study of the Japanese Association for Acute Medicine disseminated intravascular coagulation scoring system in patients with severe sepsis
    Gando, Satoshi
    Saitoh, Daizoh
    Ogura, Hiroshi
    Fujishima, Seitaro
    Mayumi, Toshihiko
    Araki, Tsunetoshi
    Ikeda, Hiroto
    Kotani, Joji
    Kushimoto, Shigeki
    Miki, Yasuo
    Shiraishi, Shin-ichiro
    Suzuki, Koichiro
    Suzuki, Yasushi
    Takeyama, Naoshi
    Takuma, Kiyotsugu
    Tsuruta, Ryosuke
    Yamaguchi, Yoshihiro
    Yamashita, Norio
    Aikawa, Naoki
    [J]. CRITICAL CARE, 2013, 17 (03):
  • [8] Performance Evaluation of Five Different Disseminated Intravascular Coagulation (DIC) Diagnostic Criteria for Predicting Mortality in Patients with Complicated Sepsis
    Ha, Sang Ook
    Park, Sang Hyuk
    Hong, Sang-Bum
    Jang, Seongsoo
    [J]. JOURNAL OF KOREAN MEDICAL SCIENCE, 2016, 31 (11) : 1838 - 1845
  • [9] Helms J, 2020, ANN INTENSIVE CARE, V10, P1
  • [10] Diagnosis of overt disseminated intravascular coagulation: A comparative study using criteria from the international society versus the Korean society on thrombosis and hemostasis
    Lee, Jong Hwa
    Song, Jae Woo
    Song, Kyung Soon
    [J]. YONSEI MEDICAL JOURNAL, 2007, 48 (04) : 595 - 600