Lili Luo1, Yingying Wu1, Ting Niu2, Yue Han3, Ying Feng4, Qiulan Ding5, Ruibin Huang6, Xiaohui Zhang7, Jianming Feng8, Ming Hou9, Jun Peng9, Yan Li10, Yuhong Zhou11, Lei Su12, Linhua Yang13, Zeping Zhou14, Feng Xue15, Jian Gu16, Tienan Zhu17, Xiaomin Wang18, Jun Deng1, Heng Mei19, Yu Hu20. 1. Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. 2. Department of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China. 3. Department of Hematology, First Affiliated Hospital of Soochow University, Suzhou 215006, China. 4. Department of Hematology, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China. 5. Department of laboratory medicine, Ruijin Hospital Affiliated to Shanghai JiaoTong University School of Medicine, Shanghai 200025, China. 6. Department of Hematology, First Affiliated Hospital of Nanchang University, Nanchang 330006, China. 7. Department of Hematology, Peking University People's Hospital, Beijing 100044, China. 8. Department of Hematology, Qinghai Provincial People's Hospital, Xining 810007, China. 9. Department of Hematology, Qilu Hospital of Shandong University, Jinan 250012, China. 10. Department of Hematology, First Hospital of China Medical University, Shenyang 110001, China. 11. Department of Hematology, First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang 310006, China. 12. Department of Intensive Care Unit, General Hospital of Guangzhou Military Command, Guangzhou 510010, China. 13. Department of Hematology, Second Hospital of Shanxi Medical University, Shanxi 030001, China. 14. Department of Hematology, Second Affiliated Hospital of Kunming Medical College, Kunming 650101, China. 15. Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China. 16. Department of Hematology, Clinical Medical College of Yangzhou University, Jiangsu 225001, China. 17. Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China. 18. Department of Hematology, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang 830001, China. 19. Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. Electronic address: hmei@hust.edu.cn. 20. Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. Electronic address: dr_huyu@126.com.
Abstract
INTRODUCTION: Disseminated intravascular coagulation (DIC) is a severe complication of critical conditions. There are several scoring systems used for the diagnosis of DIC, including the International Society on Thrombosis and Hemostasis (ISTH) Overt-DIC criteria, the Japanese Ministry of Health and Welfare (JMHW) criteria and the Chinese Society of Thrombosis and Hemostasis scoring system for DIC (CDSS). The objective of this prospective study was to evaluate the accuracy and predictive value of the CDSS. MATERIALS AND METHODS: 1318 patients, aged 18-70 years old and suspected of DIC were enrolled from 18 hospitals across China. Participants were divided into two groups for analysis (group 1, non-hematological diseases; group 2, hematological diseases). 242 patients were excluded because of incomplete data collection and failure to follow-up. RESULTS AND CONCLUSIONS: The rates of concordance of diagnosis of DIC between the CDSS and two other scoring systems were close to 80%. The area under ROC curves of CDSS had a slight advantage when using the ISTH, JMHW criteria or prognosis as gold standard, respectively. The CDSS DIC was an independent predictor of mortality, and its odds-ratio was superior or comparable to that of the ISTH and JMHW criteria in the two groups. The CDSS DIC score also had a significant correlation with the APACHE II and SOFA score (p < 0.05). In summary, as a quantification standard of the Chinese experts' consensus, the CDSS is conducive to the standardized diagnosis of DIC because of its favorable diagnostic and prognostic utility.
INTRODUCTION: Disseminated intravascular coagulation (DIC) is a severe complication of critical conditions. There are several scoring systems used for the diagnosis of DIC, including the International Society on Thrombosis and Hemostasis (ISTH) Overt-DIC criteria, the Japanese Ministry of Health and Welfare (JMHW) criteria and the Chinese Society of Thrombosis and Hemostasis scoring system for DIC (CDSS). The objective of this prospective study was to evaluate the accuracy and predictive value of the CDSS. MATERIALS AND METHODS: 1318 patients, aged 18-70 years old and suspected of DIC were enrolled from 18 hospitals across China. Participants were divided into two groups for analysis (group 1, non-hematological diseases; group 2, hematological diseases). 242 patients were excluded because of incomplete data collection and failure to follow-up. RESULTS AND CONCLUSIONS: The rates of concordance of diagnosis of DIC between the CDSS and two other scoring systems were close to 80%. The area under ROC curves of CDSS had a slight advantage when using the ISTH, JMHW criteria or prognosis as gold standard, respectively. The CDSS DIC was an independent predictor of mortality, and its odds-ratio was superior or comparable to that of the ISTH and JMHW criteria in the two groups. The CDSS DIC score also had a significant correlation with the APACHE II and SOFA score (p < 0.05). In summary, as a quantification standard of the Chinese experts' consensus, the CDSS is conducive to the standardized diagnosis of DIC because of its favorable diagnostic and prognostic utility.
Authors: Tzu-Fei Wang; Robert S Makar; Darko Antic; Jerrold H Levy; James D Douketis; Jean M Connors; Marc Carrier; Jeffrey I Zwicker Journal: J Thromb Haemost Date: 2020-12 Impact factor: 5.824