Agreement on Overt Disseminated Intravascular Coagulation in Sepsis Patients between International Society of Thrombosis and Haemostasis Criteria and Japanese Ministry of Health and Welfare Criteria
Abstract
Disseminated Intravascular Coagulation (DIC) is an acquired syndrome characterized by the activation of intravascular coagulation which is most commonly caused by sepsis. There are two types of DIC disease: overt and non-overt DICs. The International Society of Thrombosis and Haemostasis (ISTH) criteria are more frequently used in the diagnosis of overt DIC compared to Japanese Ministry of Health and Welfare (JMHW). One of the different parameters of the two criteria is the D-Dimer element in the ISTH criteria and Fibrin Degradation Products (FDP) in the JMHW criteria. The availability of fibrin-related markers is different in each health center. This study aimed to see the agreement of the DIC diagnosis based on the ISTH and JMHW criteria and to analyze the correlation between D-Dimer and FDP in sepsis patients to help clinician decide which criteria is better to use. An analytical cross-sectional study was carried out on patients with sepsis based on the clinical diagnosis from the laboratory order forms and the DIC criteria according to the ISTH and JMHW. Patients included in this study were those visiting Dr. Hasan Sadikin General Hospital Bandung from August 2019-April 2020. Data collected were analyzed statistically using Cohen's Kappa test and Spearman test, both were performed in SPSS 17.0 program.There were 35 subjects participating in this study with overt and non-overt DIC with a composition based on the ISTH and JMHW criteria of 31 and 19 vs. 4 and 16, respectively. The Kappa coefficient between ISTH and JMHW was 0.266 (p 0.021) and the correlation between the D-Dimer and the FDP was 0.88 based on the Spearman test. There is a fair agreement on the DIC diagnosis and strong correlation between the FDP and the D-Dimer in sepsis patients when assessed using the ISTH and JMHW criteria. Both criteria are equally able to assist clinicians in determining the type of DIC depending on the type of fibrin-related markers available in the health centers.
Keywords
Full Text:
PDFReferences
Levi M, van der Poll T. Coagulation and sepsis. Thromb Res. 2017;149:38–44.
Longo D, Fauci A, Kasper D, Hauser S, Jameson L, Loscalzo J. Coagulation disorders. In: Harrison Principles Intemal Medicine. 20th ed. McGraw-Hill Medical; 2018.
Toh C-H, Yasir A, .Abrams ST. Current Pathological and Laboratory considerations in the diagnosis of disseminated intravascular coagulation. Ann Lab Med. 2016;36:505–12.
Iba T, Di Nisio M, Thachil J, Wada H, Asakura H, Sato K, et al. A Proposal of the modification of Japanese Society on Thrombosis and Hemostasis (JSTH) Disseminated Intravascular Coagulation (DIC) Diagnostic Criteria for Sepsis-Associated DIC. Clin Appl Thromb. 2018;24(3):439–45.
DIC subcommittee of the Japanese Society on Thrombosis and Hemostasis, Asakura H, Takahashi H, Uchiyama T, Eguchi Y, Okamoto K, et al. Proposal for new diagnostic criteria for DIC from the Japanese Society on thrombosis and hemostasis. Thromb J. 2016;14(1):42.
Toh JMH, Ken-Dror G, Downey C, Abrams ST. The clinical utility of fibrin-related biomarkers in sepsis. Blood Coagul Fibrinolysis Int J Haemost Thromb. 2013;24(8):839–43.
Ha SO, Park SH, Hong S-B, Jang S. Performance evaluation of five different disseminated intravascular coagulation (DIC) Diagnostic criteria for predicting mortality in patients with complicated sepsis. J Korean Med Sci. 2016;31(11):1838.
Stang LJ. D-dimer and fibrinogen/fibrin degradation products. Methods Mol Biol Clifton NJ. 2013;992:415–27.
Riley RS, Gilbert AR, Dalton JB, Pai S, McPherson RA. Widely used types and clinical applications of d-dimer assay. Lab Med. 2016;47(2):90–102.
Hunt BJ. Bleeding and coagulopathies in critical care. N Engl J Med. 2014 ;370(9):847–59.
Cillóniz C, Dominedò C, Magdaleno D, Ferrer M, Gabarrús A, Torres A. Pure viral sepsis secondary to community-acquired pneumonia in adults: risk and prognostic factors. J Infect Dis. 2019;220(7):1166–171.
Wang Z, Li X, Zhu R, Zhang ZD, Ma XC. A reevaluation of diagnostic efficacy of International Society of Thrombosis and Haemostasis and Japanese Association for Acute Medicine criteria for the diagnosis of sepsis disseminated intravascular coagulation. Zhonghua Nei Ke Za Zhi. 2019;58(5):355–60.
Sato N, Takahashi H, Shibata A. Fibrinogen/fibrin degradation products and D-dimer in clinical practice: Interpretation of discrepant results. Am J Hematol. 1995;48(3):168–74.
Tanswell P, Nieuwenhuizen W, Seifried E. Pharmacokinetics of degradation products of fibrin and fibrinogen during alteplase therapy of acute myocardial infarction. Fibrinolysis. 1993;7(6):408–15.
DOI: https://doi.org/10.15395/mkb.v53n4.2398
Article Metrics
Abstract view : 814 timesPDF - 453 times
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
MKB is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
View My Stats