Newly Proposed Sepsis-Induced Coagulopathy Precedes International Society on Thrombosis and Haemostasis Overt-Disseminated Intravascular Coagulation and Predicts High Mortality

Iba, Toshiaki; Arakawa, Makoto; Nisio, Marcello Di; Gando, Satoshi; Anan, Hideaki; Sato, Koichi; Ueki, Yutaka; Levy, Jerrold H.; Thachil, Jecko

doi:10.1177/0885066618773679

Cited by 73 publications

(74 citation statements)

References 30 publications

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“…As a result, almost all the patients with overt‐DIC had SIC, and SIC had preceded overt‐DIC in every case. The mortality rate for overt‐DIC was significantly higher than that for SIC (32.5% versus 23.1%) . A comparison of the SIC and JAAM DIC criteria was also carried out, and the prevalence of patients with SIC was comparable to that of patients with JAAM DIC.…”

Section: Future Perspectivesmentioning

confidence: 98%

Diagnosis of sepsis‐induced disseminated intravascular coagulation and coagulopathy

Iba

Umemura

Watanabe

et al. 2019

Acute Medicine & Surgery

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Disseminated intravascular coagulation (DIC) is a frequent complication in sepsis. Once patients develop DIC, the mortality rate increases significantly. Moreover, recent studies have suggested that coagulation disorder plays a significant role in the development of organ dysfunction in sepsis. Thus, the early detection of DIC is vital in sepsis care, and the Japanese Association for Acute Medicine established a set of original diagnostic criteria in 2006 (JAAM DIC). Since then, the usefulness of the JAAM DIC has been repeatedly reported, and these criteria have been widely adopted in emergency and critical care settings in Japan. Different criteria have also been released by the International Society on Thrombosis and Haemostasis (ISTH overt‐DIC), and the latter criteria are presently considered to be the international standard. Compared with the JAAM DIC, the ISTH overt‐DIC criteria are stricter and the timing of diagnosis is later. This discrepancy is because of conceptual differences. As many physicians think sepsis‐associated DIC is the target of anticoagulant therapies in Japan, the JAAM DIC criteria were designed to allow the early initiation of treatment. As other countries do not provide DIC‐specific treatments, early diagnosis is not necessary, and this situation has led to a significant gap. However, as overt‐DIC is a late‐phase coagulation disorder, a need for early detection has been advocated, and members of the ISTH have recently proposed the category of sepsis‐induced coagulopathy. In this review, we introduce the strengths and weaknesses of the major criteria including JAAM‐DIC, ISTH overt‐DIC, sepsis‐induced coagulopathy, and Japanese Society on Thrombosis and Haemostasis‐DIC.

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Section: Future Perspectivesmentioning

confidence: 98%

Diagnosis of sepsis‐induced disseminated intravascular coagulation and coagulopathy

Iba

Umemura

Watanabe

et al. 2019

Acute Medicine & Surgery

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“…The usefulness of the SIC score has been validated . The ISTH DIC SSC members compared SIC and ISTH overt DIC scoring systems in sepsis patients with coagulopathy . It was found that almost all patients with overt DIC also met criteria for SIC, and that SIC preceded overt DIC in every case.…”

Section: Diagnosis Of Sepsis‐associated Dic and Sicmentioning

confidence: 99%

“…[25][26][27][28] The ISTH DIC SSC members compared SIC and ISTH overt DIC scoring systems in sepsis patients with coagulopathy. 25 It was found that almost all patients with overt DIC also met criteria for SIC, and that SIC preceded overt DIC in every case. In another study, SIC criteria appeared to identify a patient group similar to that identified using JAAM DIC criteria.…”

Section: Range Rangementioning

confidence: 99%

Diagnosis and management of sepsis‐induced coagulopathy and disseminated intravascular coagulation

Iba

Levy

Warkentin

et al. 2019

Journal of Thrombosis and Haemostasis

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379

282

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“…26 Recently, active members of the ISTH DIC-SSC recently proposed a simpler version for the diagnosis of SIC that is composed of only three items: sepsis-3 definitions (infection with organ dysfunction), platelet count, and the prothrombin time ratio 27 (►Table 1). The usefulness of these SIC diagnostic criteria has been validated, and Iba et al 28 reported that it provides an earlier diagnosis and includes most cases of ISTH overt DIC. An additional analysis of septic patients from Japan evaluated associations between in-hospital mortality and anticoagulant therapy according to the SIC or ISTH overt DIC sets of criteria.…”

Section: Diagnosis Of Disseminated Intravascular Coagulation Diagnostmentioning

confidence: 99%

Sepsis-Induced Coagulopathy and Disseminated Intravascular Coagulation

Iba

Levi

Levy

2019

Semin Thromb Hemost

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157

115

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Disseminated intravascular coagulation (DIC) has been recognized as a deadly complication in sepsis, and its early recognition followed by appropriate management of the underlying infection are the current management strategies. The activation of coagulation, inflammation, and other pathways are fundamental host responses against infection but also produce injury to the host. Recent advances have helped define the critical roles of thrombus formation in overcoming infection. In addition to activation of coagulation induced by pathogens, other important pathways including damage-associated molecular patterns, neutrophil extracellular traps, extracellular vesicles, and glycocalyx damage are involved in the pathogenesis of sepsis-induced DIC. The hallmark of DIC is thrombosis in the microvasculature; however, sepsis-induced DIC is a laboratory diagnosis based on coagulation test results and clinical setting. Although simplified criteria were recently introduced, DIC should be distinguished from other similar conditions such as thrombotic microangiopathy and heparin-induced thrombocytopenia. In DIC, treating the underlying cause is crucial, and additional adjunct therapies including antithrombin, thrombomodulin, and heparins may have potential benefit, but evidence supporting their use in terms of improvement of clinically relevant outcomes continues to be debated. In this review, we introduce recent findings regarding the pathophysiology, diagnosis, and treatment of sepsis-induced DIC. In addition, we also discuss future potential therapeutic approaches regarding this complex, life-threatening complication.

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Newly Proposed Sepsis-Induced Coagulopathy Precedes International Society on Thrombosis and Haemostasis Overt-Disseminated Intravascular Coagulation and Predicts High Mortality

Cited by 73 publications

References 30 publications

Diagnosis of sepsis‐induced disseminated intravascular coagulation and coagulopathy

Diagnosis of sepsis‐induced disseminated intravascular coagulation and coagulopathy

Diagnosis and management of sepsis‐induced coagulopathy and disseminated intravascular coagulation

Sepsis-Induced Coagulopathy and Disseminated Intravascular Coagulation

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