Shinjiro Saito1, Shigehiko Uchino2, Mineji Hayakawa3, Kazuma Yamakawa4, Daisuke Kudo5, Yusuke Iizuka6, Masamitsu Sanui6, Kohei Takimoto7, Toshihiko Mayumi8, Yusuke Sasabuchi9. 1. Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Japan. 2. Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Japan. Electronic address: s.uchino@mac.com. 3. Emergency and Critical Care Center, Hokkaido University Hospital, Japan. 4. Division of Trauma and Surgical Critical Care, Osaka General Medical Center, Japan. 5. Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Japan. 6. Department of Anesthesiology and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Japan. 7. Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Japan. 8. Department of Emergency Medicine, University of Occupational and Environmental Health, Japan. 9. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Japan.
Abstract
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.
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.
Authors: Katherine M Reitz; Jason Kennedy; Caroline Rieser; Callie Hlavin; Hayley B Gershengorn; Matthew D Neal; Nicole Bensen; Kelsey Linstrum; Hallie C Prescott; Matthew R Rosengart; Victor Talisa; Daniel E Hall; Edith Tzeng; Hannah Wunsch; Sachin Yende; Derek C Angus; Christopher W Seymour Journal: Ann Am Thorac Soc Date: 2022-04
Authors: Felix Carl Fabian Schmitt; Vasil Manolov; Jakob Morgenstern; Thomas Fleming; Stefan Heitmeier; Florian Uhle; Mohammed Al-Saeedi; Thilo Hackert; Thomas Bruckner; Herbert Schöchl; Markus Alexander Weigand; Stefan Hofer; Thorsten Brenner Journal: Ann Intensive Care Date: 2019-01-30 Impact factor: 6.925