Epidemiology of disseminated intravascular coagulation in sepsis and validation of scoring systems

被引：57

作者：

Saito, Shinjiro ^{[1
]}

Uchino, Shigehiko ^{[1
]}

Hayakawa, Mineji ^{[2
]}

Yamakawa, Kazuma ^{[3
]}

Kudo, Daisuke ^{[4
]}

Iizuka, Yusuke ^{[5
]}

Sanui, Masamitsu ^{[5
]}

Takimoto, Kohei ^{[6
]}

Mayumi, Toshihiko ^{[7
]}

Sasabuchi, Yusuke ^{[8
]}

Azuhata, Takeo ^{[9
]}

Ito, Fumihito ^{[10
]}

Yoshihiro, Shodai ^{[11
]}

Hayakawa, Katsura ^{[12
]}

Nakashima, Tsuyoshi ^{[13
]}

Ogura, Takayuki ^{[14
]}

Noda, Eiichiro ^{[15
]}

Nakamura, Yoshihiko ^{[16
]}

Sekine, Ryosuke ^{[17
]}

Yoshikawa, Yoshiaki ^{[18
]}

Sekino, Motohiro ^{[19
]}

Ueno, Keiko ^{[20
]}

Okuda, Yuko ^{[21
]}

Watanabe, Masayuki ^{[22
]}

Tampo, Akihito ^{[23
]}

Saito, Nobuyuki ^{[24
]}

Kitai, Yuya ^{[25
]}

Takahashi, Hiroki ^{[26
]}

Kobayashi, Iwao ^{[27
]}

Kondo, Yutaka ^{[28
]}

Matsunaga, Wataru ^{[29
]}

Nachi, Sho ^{[30
]}

Miike, Toru ^{[31
]}

Takahashi, Hiroshi ^{[32
]}

Takauji, Shuhei ^{[33
]}

Umakoshi, Kensuke ^{[34
]}

Todaka, Takafumi ^{[35
]}

Kodaira, Hiroshi ^{[36
]}

Andoh, Kohkichi ^{[37
]}

Kasai, Takehiko ^{[38
]}

Iwashita, Yoshiaki ^{[39
]}

Arai, Hideaki ^{[40
]}

Murata, Masato ^{[41
]}

Yamane, Masahiro ^{[42
]}

Shiga, Kazuhiro ^{[43
]}

Hori, Naoto ^{[44
]}

机构：

[1] Jikei Univ, Sch Med, Dept Anesthesiol, Intens Care Unit, Tokyo, Japan

[2] Hokkaido Univ Hosp, Emergency & Crit Care Ctr, Sapporo, Hokkaido, Japan

[3] Osaka Gen Med Ctr, Div Trauma & Surg Crit Care, Osaka, Japan

[4] Tohoku Univ, Grad Sch Med, Div Emergency & Crit Care Med, Sendai, Miyagi, Japan

[5] Jichi Med Univ, Saitama Med Ctr, Dept Anesthesiol & Crit Care Med, Shimotsuke, Japan

[6] Osaka Univ, Grad Sch Med, Dept Anesthesiol & Intens Care Med, Suita, Osaka, Japan

[7] Univ Occupat & Environm Hlth, Dept Emergency Med, Kitakyushu, Fukuoka, Japan

[8] Univ Tokyo, Grad Sch Med, Dept Hlth Serv Res, Tokyo, Japan

[9] Nihon Univ, Sch Med, Tokyo, Japan

[10] Ohta Nishinouchi Hosp, Ohta Gen Hosp Fdn, Koriyama, Fukushima, Japan

[11] JA Hiroshima Gen Hosp, Hatsukaichi, Japan

[12] Saitama Red Cross Hosp, Saitama, Japan

[13] Wakayama Med Univ, Wakayama, Japan

[14] Japan Red Cross Maebashi Hosp, Maebashi, Gunma, Japan

[15] Kyushu Univ Hosp, Fukuoka, Fukuoka, Japan

[16] Fukuoka Univ Hosp, Fukuoka, Fukuoka, Japan

[17] Ibaraki Cent Hosp, Kasama, Ibaraki, Japan

[18] Osaka Gen Med Ctr, Osaka, Japan

[19] Nagasaki Univ Hosp, Nagasaki, Japan

[20] Tokyo Med Univ, Hachioji Med Ctr, Tokyo, Japan

[21] Japan Red Cross Kyoto Daiichi Hosp, Kyoto, Japan

[22] Saiseikai Yokohamasi Tobu Hosp, Yokohama, Kanagawa, Japan

[23] Asahikawa Med Univ, Asahikawa, Hokkaido, Japan

[24] Nippon Med Sch Chiba Hokusoh Hosp, Inzai, Japan

[25] Kameda Med Ctr, Kamogawa, Japan

[26] Osaka Univ, Grad Sch Med, Suita, Osaka, Japan

[27] Asahikawa Red Cross Hosp, Asahikawa, Hokkaido, Japan

[28] Univ Ryukyus, Nishihara, Okinawa, Japan

[29] Jichi Med Univ, Saitama Med Ctr, Shimotsuke, Japan

[30] Gifu Univ Hosp, Gifu, Japan

[31] Saga Univ Hosp, Saga, Japan

[32] Steel Mem Muroran Hosp, Muroran, Hokkaido, Japan

[33] Sapporo City Gen Hosp, Sapporo, Hokkaido, Japan

[34] Ehime Univ Hosp, Toon, Japan

[35] Tomishiro Cent Hosp, Tomigusuku, Japan

[36] Akashi City Hosp, Akashi, Hyogo, Japan

[37] Sendai City Hosp, Sendai, Miyagi, Japan

[38] Hakodate Municipal Hosp, Hakodate, Hokkaido, Japan

[39] Mie Univ Hosp, Tsu, Mie, Japan

[40] Univ Occupat & Environm Hlth, Kitakyushu, Fukuoka, Japan

[41] Gunma Univ, Maebashi, Gunma, Japan

[42] KKR Sapporo Med Ctr, Sapporo, Hokkaido, Japan

[43] Seirei Mikatahara Gen Hosp, Hamamatsu, Shizuoka, Japan

[44] Hyogo Coll Med, Nishinomiya, Hyogo, Japan

来源：

JOURNAL OF CRITICAL CARE | 2019年 / 50卷

关键词：

Disseminated intravascular coagulation; Sepsis; Intensive care unit; Mortality; INFLAMMATORY RESPONSE SYNDROME; INTENSIVE-CARE UNITS; DIAGNOSTIC-CRITERIA; INTERNATIONAL SOCIETY; JAPANESE ASSOCIATION; SEPTIC SHOCK; MULTICENTER; DEFINITIONS; THROMBOSIS; MORTALITY;

D O I：

10.1016/j.jcrc.2018.11.009

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose: We investigated the epidemiology and outcome of disseminated intravascular coagulation (DIC) in patients with sepsis. Materials and methods: We analyzed data from a multicenter observational study (Japan Septic Disseminated Intravascular Coagulation [JSEPTIC-DIC] study) conducted in 42 intensive care units in Japan. DIC scores were calculated using two scoring systems: the International Society on Thrombosis and Haemostasis (ISTH) and Japanese Association for Acute Medicine (JAAM) criteria. We compared demographics and clinical characteristics of patients with and without DIC, and performed multivariable logistic regression analyses to assess the association of diagnosis and scores for DIC with in-hospital mortality. Results: Of 1895 eligible patients, 1162 (61%) and 554 patients (29%) were diagnosed as having DIC by the JAAM and ISTH criteria, respectively. Patients with DIC had higher in-hospital mortality compared with those without DIC (33% vs. 20% in JAAM and 38% vs. 24% in ISTH). However, in multivariable analysis, the JAAM score (odds ratio 1.026, 95% confidence interval 0.958-1.097; p = 0.465) and the ISTH score (odds ratio 1.049, 95% confidence interval 0.969-1.135; p = 0.238) did not have an independent association with in-hospital mortality. Conclusions: Patients with sepsis and DIC have high mortality. However, the DIC are not independently associated with in-hospital mortality. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：23 / 30

页数：8

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