Mahashabde Madhulika L, Sriram Jugal
General Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.
Cureus. 2024 Aug 18;16(8):e67134. doi: 10.7759/cureus.67134. eCollection 2024 Aug.
Aim The aim of the present study was to assess the disseminated intravascular coagulation (DIC) and its correlation with DIC scores (International Society on Thrombosis and Haemostasis (ISTH), sepsis-induced coagulopathy (SIC)) and Sequential Organ Failure Assessment (SOFA) score in medical intensive care unit (MICU) patients. Methods The study was conducted at the medical intensive care unit at Dr. D.Y. Patil Medical College and Hospital, D.Y. Patil Vidyapeeth, Pimpri, Pune spanning from October 2020 to September 2022. A total of 100 patients admitted to the hospital ICU satisfying qSOFA score were included in the current study. Approval was obtained from the institutional ethics committee before commencing the study. All patients and their family members included in the study were provided with a detailed explanation of the study. Clinical history of illness and physical examination were done in detail. The laboratory values were obtained and were calculated with the International Society on Thrombosis and Haemostasis (ISTH), sepsis-induced coagulopathy (SIC) and Sequential Organ Failure Assessment (SOFA) scores. Results The average age of the study population was 52.08 ± 16.44 years. Within the study population, 65% were male and 35% were female. Within the group being studied, the average pulse rate was 66.64 ± 17.33 beats per minute, the average systolic blood pressure was 83.7 ± 11.38 mm Hg, the average diastolic blood pressure was 59.7 ± 10.49 mm Hg, and the average respiratory rate was 38.4 ± 4.8. The average Glasgow Coma Scale (GCS) among the participants was 9.51 ± 1.74. The average qSOFA score across the study participants was 2.58 ± 0.6. The study population consisted of 60% survivors and 40% non-survivors. Regarding the study population, 57.15% of individuals experienced mortality as a result of DIC. The statistical analysis revealed a significant difference in the mean ISTH score between the result groups at 48 hours. The disparity in the average SOFA score at admission, 24 hours, 48 hours, day 7 and day 14 between the outcomes (survivors and non-survivors) was statistically significant. Conclusion This research suggests that there is a positive link between higher scores on the estimated ISTH, SIC and SOFA scales. The prognosis of critically sick patients is negatively correlated with the progressive increase in DIC scores throughout follow-up, while a stable or declining DIC score is indicative of a more favorable prognosis. There was no significant link seen between non-overt disseminated intravascular coagulation (DIC) mortality and DIC scores.
目的 本研究旨在评估医学重症监护病房（MICU）患者的弥散性血管内凝血（DIC）及其与DIC评分（国际血栓与止血学会（ISTH）、脓毒症诱导的凝血病（SIC））和序贯器官衰竭评估（SOFA）评分的相关性。方法 本研究在位于浦那市平普里的迪帕克·帕蒂尔医学学院和医院的医学重症监护病房进行，时间跨度为2020年10月至2022年9月。共有100名入住医院ICU且满足qSOFA评分的患者纳入本研究。在开始研究前获得了机构伦理委员会的批准。纳入研究的所有患者及其家属均得到了关于本研究的详细解释。详细记录了疾病的临床病史和体格检查情况。获取了实验室检查值，并计算了国际血栓与止血学会（ISTH）、脓毒症诱导的凝血病（SIC）和序贯器官衰竭评估（SOFA）评分。结果 研究人群的平均年龄为52.08±16.44岁。在研究人群中，65%为男性，35%为女性。在被研究组中，平均脉搏率为66.64±17.33次/分钟，平均收缩压为83.7±11.38毫米汞柱，平均舒张压为59.7±10.49毫米汞柱，平均呼吸频率为38.4±4.8。参与者的平均格拉斯哥昏迷量表（GCS）评分为9.51±1.74。整个研究参与者的平均qSOFA评分为2.58±0.6。研究人群中60%为幸存者，40%为非幸存者。在研究人群中，57.15%的个体因DIC死亡。统计分析显示，48小时时结果组之间的平均ISTH评分存在显著差异。在入院时、24小时、48小时、第7天和第14天，结局（幸存者和非幸存者）之间的平均SOFA评分差异具有统计学意义。结论 本研究表明，估计的ISTH、SIC和SOFA量表得分越高之间存在正相关。危重病患者的预后与随访期间DIC评分的逐渐升高呈负相关，而DIC评分稳定或下降则表明预后更有利。未观察到非显性弥散性血管内凝血（DIC）死亡率与DIC评分之间存在显著关联。
