Medical Examination and Clinical Diagnosis

Values of different DIC scoring systems in early diagnosis and prognosis prediction of coagulation dysfunction in sepsis patients

  • Fangmin GENG ,
  • Yuandan HE ,
  • Wenjuan LI ,
  • Qianqian LIU ,
  • Hongwei ZHANG ,
  • Zhangping LU ,
  • Lianhua WEI
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  • Gansu University of Traditional Chinese Medicine,Lanzhou 730000,China

Received date: 2023-08-21

  Online published: 2024-03-06

Abstract

Objective To evaluate five types of DIC scoring systems based on sepsis patients, to explore the values of different DIC scoring systems in the occurrence and prognosis of DIC in sepsis patients, and to compare the applicability of different DIC scoring systems for sepsis complicated with DIC. Methods Laboratory indexes and clinical data from sepsis patients who had been hospitalized in Gansu Provincial People's Hospital from December 1, 2019 to December 31, 2021 were retrospectively analyzed within 24 hours. Five types of DIC scoring systems were used to score, and the difference of diagnostic rate and discharge outcome in sepsis patients with different severity was compared. The ROC curves of five DIC scoring systems were established to evaluate the accuracy of DIC in sepsis patients. Results The fatality rate of sepsis increased with the severity of sepsis (P < 0.05). There were statistically significant differences in discharge outcomes between DIC and non-DIC in the five scoring systems (P < 0.05). JMHW, CDSS and part of ISTH were detected in JAAM cases, while ISTH was detected in non-dominant ISTH cases. ISTH, JAAM, JMHW, CDSS, and non-dominant ISTH5 scoring systems were used to diagnose DIC, and absence of full health restoration and death were 3.0, 3.8, 4.2, 3.9, and 3.0 times higher than non-DIC cases, respectively. Conclusion JAAM scoring system has higher diagnostic rate and sensitivity for adult sepsis. CDSS and JMHW scoring systems are more accurate in predicting the prognosis of sepsis patients.

Cite this article

Fangmin GENG , Yuandan HE , Wenjuan LI , Qianqian LIU , Hongwei ZHANG , Zhangping LU , Lianhua WEI . Values of different DIC scoring systems in early diagnosis and prognosis prediction of coagulation dysfunction in sepsis patients[J]. The Journal of Practical Medicine, 2024 , 40(2) : 248 -252 . DOI: 10.3969/j.issn.1006-5725.2024.02.021

References

1 MICHELA G, HANNE EHELINDER B, DARIO B, et al. Coagulopathy and sepsis: Pathophysiology, clinical manifestations and treatment[J]. Blood Rev,2021,50:100864. doi:10.1016/j.blre.2021.100864
2 EVANS L, RHODES A, ALHAZZANI W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021[J].Intenstive Care Med,2021,47(11):1181-1247.
3 RUDD K, JOHNSON S, AGESA K, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study[J]. Lancet,2020,395(10219):200-211. doi:10.1016/s0140-6736(19)32989-7
4 张杰,李小悦,黄家华,等. 脓毒症相关肝损伤与肠-肝轴研究进展[J].实用医学杂志,2022,38(7):795-798. doi:10.3969/j.issn.1006-5725.2022.07.004
5 LEVIL M, TENC H. Disseminated intravascular coagulation [J].N Engl J Med,1999,341:586-592. doi:10.1056/nejm199908193410807
6 RHODES A, EVANS L, ALHAZZANI W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016[J]. Crit Care Med, 2017, 45(3): 486-552.
7 CHURPEK M, SNYDER A, HAN X, et al. Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit[J]. Am J Respir Crit Care Med, 2017, 195(7): 906-911. doi:10.1164/rccm.201604-0854oc
8 TACKE F, RDERBURG C, BENZ F, et al. Levels of circulating miR-133a are elevated in sepsis and predict mortality in critically ill patients [J]. Crit Care Med, 2014, 42(5): 1096-1104. doi:10.1097/ccm.0000000000000131
9 SAMANTHA E, HOFFMAN B, BLAKE M, et al. Spinal Level and Cord Involvement Predict Sepsis Following Vertebral Fracture Repair for Traumatic Spinal Injury[J]. Neurosurg Spine,2022,4: 1-7.
10 YAMAKAWA K, YOSHIMURA J, ITO T, et al. External Validation of the two newly proposed criteriafor assessing coagulopathy in sepsis[J]. Thromb Haemost, 2019,119(2):203-212. doi:10.1055/s-0038-1676610
11 TOSHIAKI I, JERROL D, LEVY. Sepsis-induced Coagulopathy and Disseminated Intravascular Coagulation[J] .Anesthesiology,2020,132(5):1238-1245. doi:10.1097/aln.0000000000003122
12 YUTAKA U, KAZUMA Y, TAKEYUKI K, et al Design and Evaluation of New Unified Criteria for Disseminated Intravascular Coagulation Based on the Japanese Association for Acute Medicine Criteria[J]. Clin Appl Thromb Hemost, 2016,22(2):153-160. doi:10.1177/1076029615591169
13 JULIE BROGAARD L, MATHIES APPEL A, ASGER G, et al Disseminated intravascular coagulation diagnosis : Positive predictive value of the ISTH score in a Danish population [J]. Res Pract Thromb Haemost, 2021,5(8):e12636. doi:10.1002/rth2.12636
14 SINGER M, DEUTSCHMAN C, SEYMOUR C,et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)[J]. JAMA, 2016,315(8): 801–810.
15 PRIYA P, AMANDA W, MATTHEW R, et al. Markers of Inflammation and Infection in Sepsis and Disseminated Intravascular Coagulation[J].Clin Appl Thromb Hemost, 2019, 25: 1-6. doi:10.1177/1076029619843338
16 宋立成,韩志海. 脓毒症相关凝血功能障碍机制及治疗的研究进展[J]. 中华危重症医学杂志(电子版), 2017, 10(2):125-129.
17 TOSHIAKI I, MAKOTO ARAKOTO A, JERROLD H.Sepsis-inducedcoagulopathy and Japanese association for acute medicineDic in coagulopathic patients with decreased antithrombinand treated by antithrombin[J]. Clin Appl Thromb Hemost, 2018, 24(7):1020-1026. doi:10.1177/1076029618770273
18 THROMBUS AND HEMOSTASIS GROUP. Chinese Society of Hematology, Chinese Medical Association.Chinese expert Consensus on diagnosis of disseminated intravascular coagulation (2017 edition) [J]. Chin J Hematol, 2017,38 (5) : 361-363 .
19 WANG B, ZHANG B, SHEN Y, et al. Validation of two revised,simplified criteria for assessing sepsis-associated disseminated intravascular coagulation in ICU patients with sepsis-3: a retrospective study[J]. Lab Med, 2023,54(3):291-298. doi:10.1093/labmed/lmac112
20 UMEMURA Y, YAMAKAWA K. Optimal patient selection for anticoagulant therapy in sepsis: an evidence-based proposal from Japan[J]. Thromb Haemost, 2018,16(3):462-464. doi:10.1111/jth.13946
21 CHIE T, TAKASHI T, SAORI, et al. Validation of sepsis-induced coagulopathy score in critically ill patients with septic shock: post hoc analysis of a nationwide multicenter observational study in Japan[J]. Internat J Hematol,2021,114:164-171. doi:10.1007/s12185-021-03152-4
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