Central Hospital of Fenggang Town, Ganzhou Economic and Technological Development Zone, Ganzhou, Jiangxi, 341412, People's Republic of China.
Department of Clinical Laboratory, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, 341000, People's Republic of China.
J Thromb Thrombolysis. 2023 Oct;56(3):423-432. doi: 10.1007/s11239-023-02850-6. Epub 2023 Jun 23.
Acute myeloid leukemia (AML) is a heterogeneous hematological malignancy, and is one of the triggers of DIC, the latter is an essential factor in the early death of patients with AML. However, the timely identification of DIC remains a challenge. The Chinese DIC Scoring System (CDSS) is a common consensus widely used in China; but, there are few reports on its application in patients with AML. We undertake this retrospective cohort study to investigate the association between CDSS score and 60-day mortality. CDSS scores were evaluated after admission. The outcome was all-cause 60-day mortality. Multivariate Cox regression analyses were performed to calculate the adjusted hazard ratio (HR) and the corresponding 95% confidence interval (CI). Survival curves were plotted by Kaplan-Meier and log-rank analyses. Subgroup analyses were stratified by relevant effect covariates. A total of 570 consecutive patients with primary AML were included. We found an association between a 39% increase in 60-day mortality and a 1 point increase in CDSS score (HR = 1.39, 95% CI 1.25-1.54), which was associated with a 189% increase in 60-day mortality in CDSS scores ≥ 6 compared with that in the CDSS scores < 6 (HR = 2.89, 95% CI 1.91-4.38). After adjusting for all potential con-founders, a 27% and a 198% increase were observed (HR = 1.27, 95% CI 1.01-1.61; HR = 2.98, 95% CI 1.24-7.19), respectively. There is association between 60-day mortality and CDSS score in patients with AML. These findings may help hematologists in making informed treatment decisions.
急性髓系白血病（AML）是一种异质性血液恶性肿瘤，也是弥漫性血管内凝血（DIC）的触发因素之一，后者是 AML 患者早期死亡的重要因素。然而，及时识别 DIC 仍然是一个挑战。中国 DIC 评分系统（CDSS）是中国广泛使用的共识标准；但是，关于其在 AML 患者中的应用的报道很少。我们进行了这项回顾性队列研究，以调查 CDSS 评分与 60 天死亡率之间的关系。入院后评估 CDSS 评分。结局为全因 60 天死亡率。采用多变量 Cox 回归分析计算调整后的危险比（HR）和相应的 95%置信区间（CI）。通过 Kaplan-Meier 和对数秩分析绘制生存曲线。根据相关效应协变量进行亚组分析。共纳入 570 例原发性 AML 连续患者。我们发现，CDSS 评分每增加 1 分，60 天死亡率增加 39%（HR=1.39，95%CI 1.25-1.54），与 CDSS 评分≥6 分相比，60 天死亡率增加 189%（HR=2.89，95%CI 1.91-4.38）。在校正所有潜在混杂因素后，观察到 27%和 198%的增加（HR=1.27，95%CI 1.01-1.61；HR=2.98，95%CI 1.24-7.19）。AML 患者 60 天死亡率与 CDSS 评分之间存在相关性。这些发现可能有助于血液学家做出明智的治疗决策。
