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弥散性血管内凝血评分方法的叙述性综述:评估诊断准确性和临床实用性

A Narrative Review of Scoring Methods in Disseminated Intravascular Coagulation: Evaluating Diagnostic Accuracy and Clinical Utility.

作者信息

Chaithanya Pulivarthi, Meshram Revat J, Taksande Amar

机构信息

Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Aug 17;16(8):e67052. doi: 10.7759/cureus.67052. eCollection 2024 Aug.

Abstract

Disseminated intravascular coagulation (DIC) is a critical, life-threatening disorder characterized by widespread activation of the coagulation cascade, leading to microthrombi formation, consumption of clotting factors and platelets, and a paradoxically increased risk of bleeding. Accurate and timely diagnosis is crucial for effective management and improved patient outcomes. This narrative review aims to evaluate the diagnostic accuracy and clinical utility of various scoring systems used to assess DIC. We examine prominent systems, including the International Society on Thrombosis and Haemostasis (ISTH) scoring system, the Japanese Association for Acute Medicine (JAAM) DIC criteria, and other regional or institutional criteria such as the Chinese DIC scoring system (CDSS). The review compares these systems based on their criteria, sensitivity, specificity, and accuracy across different patient populations and discusses their strengths and limitations. Additionally, we explore the impact of these scoring systems on patient management and therapeutic decisions, identify challenges and limitations, and highlight emerging trends and future directions in DIC diagnosis. By providing a comprehensive analysis, this review aims to enhance understanding of DIC scoring methods and inform clinical practice to improve patient care.

摘要

弥散性血管内凝血(DIC)是一种危急的、危及生命的疾病,其特征是凝血级联反应广泛激活,导致微血栓形成、凝血因子和血小板消耗,以及出血风险反常增加。准确及时的诊断对于有效治疗和改善患者预后至关重要。本叙述性综述旨在评估用于评估DIC的各种评分系统的诊断准确性和临床实用性。我们研究了一些著名的系统,包括国际血栓与止血学会(ISTH)评分系统、日本急性医学协会(JAAM)DIC标准,以及其他地区或机构标准,如中国DIC评分系统(CDSS)。该综述根据这些系统的标准、敏感性、特异性和在不同患者群体中的准确性进行比较,并讨论它们的优势和局限性。此外,我们探讨了这些评分系统对患者管理和治疗决策的影响,识别挑战和局限性,并突出DIC诊断中的新兴趋势和未来方向。通过提供全面的分析,本综述旨在增进对DIC评分方法的理解,并为临床实践提供参考,以改善患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834a/11405081/b0c337f4d478/cureus-0016-00000067052-i01.jpg

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