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

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Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo
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Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo

Published on: August 4, 2018

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Juergen Grafeneder1,2, Nina Buchtele3, Daniel Egger1

  • 1Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.

Thrombosis and Haemostasis
|August 16, 2022
PubMed

Insights

The International Society on Thrombosis and Haemostasis

Area of Science:

  • Hematology
  • Hepatology
  • Critical Care Medicine

Background:

  • The International Society on Thrombosis and Haemostasis' (ISTH) disseminated intravascular coagulation (DIC) score is used for diagnosis and mortality prediction.
  • Coagulopathy is a common complication in patients with liver disease.

Purpose of the Study:

  • To determine if the ISTH DIC score can predict 30-day mortality in patients with liver disease and low fibrinogen levels.
  • To evaluate the predictive performance of both the original (DIC-2001) and revised (DIC-2018) ISTH DIC score versions.

Main Methods:

  • Retrospective analysis of 388 patients with liver disease and low fibrinogen (<150 mg/dL) admitted to Vienna General Hospital (2003-2014).
  • Inclusion criteria: liver disease, fibrinogen <150 mg/dL, and ≥2 pathological DIC parameters.
  • Cox regression and receiver operating characteristic analyses were used to assess predictive values.

Main Results:

  • Both the DIC-2001 (HR: 2.08) and DIC-2018 (HR: 1.73) scores significantly predicted 30-day mortality in this patient cohort.
  • The predictive value remained robust across sensitivity analyses.
  • The study analyzed 388 patients, with 38% females, median age of 58 years.

Conclusions:

  • The ISTH DIC scores (both versions) are effective predictors of 30-day mortality in patients with liver disease and low fibrinogen.
  • Further research is warranted to explore the DIC score's utility and its reflection of disease complexity in this population.
Abstract

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