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Exploring the epidemiology of disseminated intravascular coagulation: protocol for the DANish Disseminated
Simon Flæng1, Søren Nygaard2, Asger Granfeldt3
1Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark siflae@clin.au.dk.
Insights
The DANish Disseminated Intravascular Coagulation (DANDIC) Cohort Study will investigate the incidence, mortality, and treatment of disseminated intravascular coagulation (DIC). This research aims to identify prognostic factors for personalized patient care and improve clinical outcomes for this serious coagulation disorder.
Area of Science:
- Clinical Medicine
- Hematology
- Epidemiology
Background:
- Disseminated intravascular coagulation (DIC) is a critical coagulation disorder posing significant clinical challenges.
- Existing knowledge gaps hinder effective patient management and treatment strategies for DIC.
Purpose of the Study:
- To determine the incidence and mortality trends of DIC.
- To identify prognostic factors for personalized prevention and treatment of DIC.
- To describe current treatment patterns, safety, and effectiveness of DIC interventions.
Main Methods:
- Establishment of the DANDIC Cohort using clinical data from the Central Denmark Region (1.3 million residents).
- Study period: January 1, 2011, to July 1, 2021.
- DIC case identification via laboratory biomarkers and expert adjudication, enriched with electronic medical chart data and linkage to national health registries.
Main Results:
- The DANDIC Cohort will provide comprehensive data on DIC patient characteristics, treatments, and outcomes.
- Longitudinal data will enable analysis of time trends and prognostic factor identification.
- Integration with national registries ensures robust, long-term follow-up for epidemiological analysis.
Conclusions:
- The DANDIC Cohort is a robust platform for advancing the understanding of DIC.
- Findings will inform evidence-based guidelines for DIC prevention and treatment.
- This study will contribute significantly to improving patient care for disseminated intravascular coagulation.
Introduction:
Since disseminated intravascular coagulation (DIC) was first described, it has been considered a serious disease of the coagulation system and a major challenge to clinicians. Currently, several important knowledge gaps remain. The DANish Disseminated Intravascular Coagulation (DANDIC) Cohort Study will aim to answer questions regarding the incidence and mortality of patients with DIC including time trends. The study will also identify prognostic factors that may guide personalised prevention and treatment. Furthermore, the study will describe treatment patterns and the safety and effectiveness of various treatment modalities.
Methods And Analysis:
We will establish the DANDIC Cohort using data collected in daily clinical practice from the Central Denmark Region, which covers approximately 1.3 million residents. The study period will encompass 1 January 2011 through 1 July 2021. Potential DIC cases will be identified from the hospital laboratory database, based on coagulation biomarkers, and diagnoses will be adjudicated by medical experts. The dataset will be enriched with detailed clinical data from electronic medical charts on aetiologies, bleeding, microthrombus formation, organ failure, thrombosis, treatments and comorbidities. The dataset will also take advantage of in-hospital data with longitudinal information on laboratory records, transfusions, microbiology and treatments. It will be possible to merge this dataset with other unique Danish health registries with more than 10 years of virtually complete follow-up. The project will use state-of-the-art epidemiological and biostatistical methods.
Ethics And Dissemination:
The project has been approved by the Danish Patient Safety Authority (31-1521-452), the Central Denmark Region (1-45-70-83-21), the Danish Data Protection Agency (1-16-02-258-21) and all the hospital chairs. Register-based studies require no ethical approval in Denmark. The results will be disseminated in international peer-reviewed journals.
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