Flæng Simon, Granfeldt Asger, Sørensen Henrik Toft, Adelborg Kasper
Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, 8200 Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark.
J Clin Med. 2024 Oct 2;13(19):5896. doi: 10.3390/jcm13195896.
Disseminated intravascular coagulation (DIC) is a severe condition affecting the coagulation system. However, current knowledge regarding its incidence and mortality remains limited. In this study, we examined the incidence and mortality of DIC, including time trends, in Denmark. In this population-based cohort study, potential DIC cases were identified through the hospital laboratory database in the Central Denmark Region which has a population of approximately 1.3 million residents. Eligibility criteria were age above 18 years, a positive DIC score, and a disease associated with DIC. All eligible patients underwent a review of their medical records. Follow-up started on the date of a patient's first positive DIC score. Age- and sex-standardized incidence rates were calculated using year-specific DIC events as the numerator and the adult population of the Central Denmark Region as the denominator. All-cause 30-day mortality in the DIC cohort was computed based on Kaplan-Meier estimates and the mortality rates between subgroups were examined using logistic regression. Among the 40,534 patients for whom all DIC biomarkers were measured on the same date, 6748 had a positive DIC score. Of these, 2565 were included in the cohort. The median age was 64 years, and 56.1% were men. The overall incidence rate per 100,000 person years declined during the study period, from 33.1 in 2013 to 24.0 in 2020. Thirty-day all-cause mortality was 35% in 2013 and 41.3% in 2020. The overall incidence rate of DIC declined between 2013 and 2020, mainly reflecting a declining incidence among patients with infection-associated DIC. Mortality did not improve.
弥散性血管内凝血(DIC)是一种影响凝血系统的严重病症。然而,目前关于其发病率和死亡率的认知仍然有限。在本研究中,我们调查了丹麦DIC的发病率和死亡率,包括时间趋势。在这项基于人群的队列研究中,通过丹麦中部地区医院实验室数据库识别潜在的DIC病例,该地区约有130万居民。纳入标准为年龄在18岁以上、DIC评分阳性且患有与DIC相关的疾病。所有符合条件的患者均对其病历进行了审查。随访从患者首次DIC评分阳性之日开始。使用特定年份的DIC事件作为分子,以丹麦中部地区的成年人口作为分母,计算年龄和性别标准化发病率。DIC队列中的全因30天死亡率基于Kaplan-Meier估计值计算,亚组间的死亡率使用逻辑回归进行检验。在同一天测量所有DIC生物标志物的40534名患者中,6748名DIC评分呈阳性。其中,2565名被纳入队列。中位年龄为64岁,男性占56.1%。在研究期间,每10万人年的总体发病率有所下降,从2013年的33.1降至2020年的24.0。2013年30天全因死亡率为35%,2020年为41.3%。2013年至2020年期间,DIC的总体发病率下降,主要反映了感染相关性DIC患者发病率的下降。死亡率并未改善。