[Disseminated intravascular coagulation. Case series and literature review].

BACKGROUND

Disseminated intravascular coagulation is an entity characterized by activation of the coagulation cascade and endogenous fibrinolysis, which can cause death. Our objectives were to identify the incidence of disseminated intravascular coagulation, its etiologic agents and the correlation between the Apache II score and the one proposed by the International Society on Thrombosis and Haemostasis for the diagnosis of this entity.

METHODS

Retrospective, descriptive, observational study of patients treated in an intensive care unit over a 17-month period. Etiology, age, sex, platelet count, coagulation tests, serum fibrinogen levels and D-dimer quantification were analyzed. The score on the scale proposed by the International Society on Thrombosis and Haemostasis and the Apache II score were calculated.

RESULTS

11 patients (7.18 % of the total number treated subjects at the intensive care unit) had a diagnosis of disseminated intravascular coagulation; six were females. Sepsis was the main etiologic agent (four cases). The most affected age group was the 51-60 years group (four cases). The prognosis was bad in seven subjects. Patients with five points or more in the DIC system, but with a low Apache II score had a good prognosis.

CONCLUSIONS

The combination of the DIC and the Apache II scores serves for predicting the outcome of patients with severe organ injuries.