Disseminated Intravascular Coagulation Score Predicts Mortality in Patients with Liver Disease and Low Fibrinogen Level.


Journal

Thrombosis and haemostasis
ISSN: 2567-689X
Titre abrégé: Thromb Haemost
Pays: Germany
ID NLM: 7608063

Informations de publication

Date de publication:
Dec 2022
Historique:
pubmed: 17 8 2022
medline: 7 12 2022
entrez: 16 8 2022
Statut: ppublish

Résumé

 Alongside its original diagnostic intention, the International Society on Thrombosis and Haemostasis' (ISTH) disseminated intravascular coagulation (DIC) score predicts mortality in various patient groups.  We investigated whether coagulopathy quantified by the DIC score can predict 30-day mortality in patients with liver disease and low fibrinogen levels.  We retrospectively analyzed all patients admitted to the Vienna General Hospital between 2003 and 2014 with a fibrinogen level of <150 mg/dL, a history of liver disease, and ≥2 pathological DIC parameters. We used a Cox regression and receiver operating characteristic analysis to assess the predictive value of the ISTH DIC score in its original (DIC-2001) and revised form (DIC-2018).  A total of 1,333 patients were screened, and 388 of these patients (38% female, median age: 58 years, interquartile range: 48-66 years) were analyzed. The DIC-2001 (hazard ratio [HR]: 2.08, 95% confidence interval [CI]: 1.78-2.59,  The ISTH DIC-2001 and DIC-2018 scores predicted 30-day mortality in patients with liver disease and low fibrinogen levels. The DIC score deserves further investigation in this population as it likely reflects different dimensions of the underlying disease.

Sections du résumé

BACKGROUND BACKGROUND
 Alongside its original diagnostic intention, the International Society on Thrombosis and Haemostasis' (ISTH) disseminated intravascular coagulation (DIC) score predicts mortality in various patient groups.
OBJECTIVES OBJECTIVE
 We investigated whether coagulopathy quantified by the DIC score can predict 30-day mortality in patients with liver disease and low fibrinogen levels.
METHODS METHODS
 We retrospectively analyzed all patients admitted to the Vienna General Hospital between 2003 and 2014 with a fibrinogen level of <150 mg/dL, a history of liver disease, and ≥2 pathological DIC parameters. We used a Cox regression and receiver operating characteristic analysis to assess the predictive value of the ISTH DIC score in its original (DIC-2001) and revised form (DIC-2018).
RESULTS RESULTS
 A total of 1,333 patients were screened, and 388 of these patients (38% female, median age: 58 years, interquartile range: 48-66 years) were analyzed. The DIC-2001 (hazard ratio [HR]: 2.08, 95% confidence interval [CI]: 1.78-2.59,
CONCLUSION CONCLUSIONS
 The ISTH DIC-2001 and DIC-2018 scores predicted 30-day mortality in patients with liver disease and low fibrinogen levels. The DIC score deserves further investigation in this population as it likely reflects different dimensions of the underlying disease.

Identifiants

pubmed: 35973781
doi: 10.1055/a-1925-2300
doi:

Substances chimiques

Fibrinogen 9001-32-5

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1980-1987

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Juergen Grafeneder (J)

Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.

Nina Buchtele (N)

Department of Medicine I - Intensive Care Unit 13i2, Medical University of Vienna, Vienna, Austria.

Daniel Egger (D)

Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.

Michael Schwameis (M)

Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.

Cihan Ay (C)

Division of Haematology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.

Bernd Jilma (B)

Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.

Christian Schoergenhofer (C)

Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.

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Classifications MeSH