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Original Article
- Infection/Hematology
- The Prevalence and Significance of Overt Disseminated Intravascular Coagulation in Patients with Septic Shock in the Emergency Department According to the Third International Consensus Definition
- Byuk Sung Ko, Hyun Young Cho, Seung Mok Ryoo, Myung Chun Kim, Woong Jung, Sung Hyuk Park, Chang Min Lee, Won Young Kim
- Korean J Crit Care Med. 2016;31(4):334-341. Published online November 30, 2016
- DOI: https://doi.org/10.4266/kjccm.2016.00339
- 9,312 View
- 173 Download
- 5 Crossref
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Abstract
PDF - Background
The prevalence and prognostic value of overt disseminated intravascular coagulation (DIC) in patients with septic shock presenting to emergency departments (EDs) is poorly understood, particularly following the release of a new definition of septic shock. The purpose of this study was to investigate the prevalence and prognostic value of DIC in septic shock.
Methods
We performed retrospective review of 391 consecutive patients with septic shock admitting to the ED of tertiary care, university-affiliated hospital during a 16-month. Septic shock was defined as fluid-unresponsive hypotension requiring vasopressor to maintain a mean arterial pressure of 65 mmHg or greater, and serum lactate level ≥ 2 mmol/L. Overt DIC was defined as an International Society on Thrombosis and Hemostasis (ISTH) score ≥ 5 points. The primary endpoint was 28-day mortality.
Results
Of 391 patients with septic shock, 290 were included in the present study. The mean age was 65.6 years, the 28-day mortality rate was 26.9%, and the prevalence of overt DIC was 17.6% (n = 51) according to the ISTH score. The median DIC score was higher in non-survivors than in survivors (5.0 vs. 2.0, p = 0.001). Significant higher risk of mortality was observed in overt DIC patients compared to those without (28.2% vs. 13.7%, p = 0.005). Multivariable logistic regression analysis identified DIC to be independently associated with 28-day mortality (odds ratio, 2.689 [95% confidence interval, 1.390-5.201]).
Conclusions
Using the ISTH criteria of DIC, overt DIC in septic shock was found to be common among patients admitting to the ED and to be associated with higher mortality when it is accompanied with septic shock. Efforts are required to identify presence of overt DIC during the initial treatment of septic shock in patients presenting the the ED. -
Citations
Citations to this article as recorded by
- Which Septic Shock Patients With Non-Overt DIC Progress to DIC After Admission? Point-of-Care Thromboelastography Testing
Sang-Min Kim, Sang-Il Kim, Gina Yu, Youn-Jung Kim, Won Young Kim
Shock.2022; 57(2): 168. CrossRef - Dysregulated haemostasis in thrombo-inflammatory disease
Paula A. Klavina, Gemma Leon, Annie M. Curtis, Roger J.S. Preston
Clinical Science.2022; 136(24): 1809. CrossRef - Disseminated Intravascular Coagulopathy in Critically Ill Patients in Amman, Jordan
Eman Mahmoud Qasim Emleek, Amani Anwar Khalil
Biological Research For Nursing.2021; 23(4): 689. CrossRef - Features of Development and Course of Disseminated Intravascular Coagulation Syndrome During Surgical Interventions in Children with Oncological Diseases
N. P. Leonov, V. V. Schukin, G. A. Novichkova, M. A. Maschan, F. I. Ataullakhanov, S. S. Yashin, A. M. Zeynalov, Е. A. Spiridonova
General Reanimatology.2020; 16(3): 54. CrossRef - Relationship between low hemoglobin levels and mortality in patients with septic shock
Sung Min Jung, Youn-Jung Kim, Seung Mok Ryoo, Won Young Kim
Acute and Critical Care.2019; 34(2): 141. CrossRef
- Which Septic Shock Patients With Non-Overt DIC Progress to DIC After Admission? Point-of-Care Thromboelastography Testing
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