The ISTH DIC score predicts outcome in non-septic patients admitted to a cardiovascular intensive care unit

Area of Science:

• Critical Care Medicine
• Hematology
• Clinical Pathology

Background:

• The International Society of Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) score is a standard prognostic tool for critically ill patients, primarily those with sepsis.
• Its utility in non-septic intensive care unit (ICU) populations remains less defined.

Purpose of the Study:

• To evaluate the predictive performance of the ISTH DIC-2001 and DIC-2018 scores for 30-day mortality in non-septic ICU patients.
• To determine if DIC scoring can be applied beyond septic conditions for mortality risk assessment.

Main Methods:

• A prospective observational study involving 167 non-septic adult patients admitted to a cardiovascular-focused medical ICU.
• Calculation of DIC-2001 and DIC-2018 scores on admission and at 72 hours.
• Classification of overt DIC based on established thresholds (≥5 for DIC-2001, ≥4 for DIC-2018).

Main Results:

• Overt DIC-2001 at admission (DIC-2001-0h), overt DIC-2018 at admission (DIC-2018-0h), and overt DIC-2001 at 72 hours (DIC-2001-72h) were significantly associated with higher 30-day mortality.
• Patients with overt DIC scores experienced substantially higher mortality rates compared to those without.
• Both DIC-2001 scores and the DIC-2018-0h score demonstrated significant predictive power for 30-day mortality.

Conclusions:

• The ISTH DIC score demonstrates applicability and utility in predicting 30-day mortality within non-septic ICU patient cohorts.
• The findings suggest that DIC scoring can serve as a valuable prognostic tool irrespective of the underlying etiology.
• Further validation in diverse non-septic ICU populations is warranted.