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[Disseminated intravascular coagulation. Case series and literature review]

Luis Del Carpio-Orantes1, Jorge José García-Ortiz

  • 1Unidad de Cuidados Intensivos, Hospital D´Maria, Veracruz, Veracruz, México. neurona23@hotmail.com.

Revista Medica Del Instituto Mexicano Del Seguro Social
|October 30, 2014
PubMed

Insights

Disseminated intravascular coagulation (DIC) affects 7.18% of ICU patients, often caused by sepsis. Combining DIC and Apache II scores predicts patient outcomes in severe organ injury.

Area of Science:

  • Critical Care Medicine
  • Hematology
  • Pathophysiology

Background:

  • Disseminated intravascular coagulation (DIC) involves coagulation cascade activation and fibrinolysis, potentially leading to death.
  • Understanding DIC incidence, causes, and diagnostic scoring is crucial for patient management.

Purpose of the Study:

  • To determine the incidence of DIC in an intensive care unit (ICU).
  • To identify the primary etiologic agents of DIC.
  • To evaluate the correlation between the Apache II score and the International Society on Thrombosis and Haemostasis (ISTH) score for DIC diagnosis.

Main Methods:

  • A retrospective, descriptive, observational study was conducted over 17 months in an ICU.
  • Data collected included etiology, demographics, platelet counts, coagulation tests, fibrinogen, and D-dimer levels.
  • Both ISTH and Apache II scores were calculated for each patient.

Main Results:

  • Eleven patients (7.18%) were diagnosed with DIC, with sepsis being the most common cause (four cases).
  • The 51-60 years age group was most affected (four cases).
  • A combination of a high ISTH score (≥5) and a low Apache II score indicated a good prognosis.

Conclusions:

  • The study highlights sepsis as a major cause of DIC in the ICU.
  • The combination of ISTH and Apache II scores can effectively predict outcomes for patients with severe organ injuries.
Abstract

Keywords:
Disseminated intravascular coagulationIntensive careSeverity of illness index

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