The thromboelastometric discrepancy between septic and trauma induced disseminated intravascular coagulation diagnosed by the scoring system from the Japanese association for acute medicine

Koami, Hiroyuki; Sakamoto, Yuichiro; Sakurai, Ryota; Ohta, Miho; Imahase, Hisashi; Yahata, Mayuko; Umeka, Mitsuru; Miike, Toru; Nagashima, Futoshi; Iwamura, Takashi; Yamada, Kosuke; Inoue, Satoshi

doi:10.1097/md.0000000000004514

Cited by 11 publications

(9 citation statements)

References 28 publications

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“…In line with a previous study [ 21 ], the results of the current study showed that the plasma fibrinogen level was not significantly different between ICU survivors and nonsurvivors, with a fibrinogen level less than 1.0 g/l only occurring in 2.4% (6/252) of patients with sepsis. Unlike traumatic coagulopathy, the fibrinogen level in sepsis, especially in early sepsis, does not decrease and may even increase [ 12 ]. However, once the fibrinogen level in patients with sepsis appears to be significantly lower, it may indicate the formation of a large amount of microthrombi in the microcirculation; this occurs when there is a shift from hypercoagulability to consumption coagulopathy and often suggests a poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Sepsis-associated DIC is characterized by activation of coagulation and an excessive inhibition of fibrinolysis with a high risk of organ dysfunction [ 8 – 10 ]. In contrast with traumatic coagulopathy, hypofibrinogenemia usually occurs at the late stage of sepsis-associated DIC [ 1 , 4 , 11 , 12 ]. Thus, in the JAAM criteria there is no ‘fibrinogen’ score, which is the main difference with the ISTH criteria [ 7 ] (Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of a new criteria for sepsis-induced coagulopathy and International Society on Thrombosis and Haemostasis disseminated intravascular coagulation score in critically ill patients with sepsis 3.0

Ding

Wang²,

Lin³

et al. 2018

Blood Coagulation &Amp; Fibrinolysis

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Recently, new criteria for sepsis-induced coagulopathy (SIC) were developed, including the sequential organ failure assessment (SOFA) criteria. The objective of this study was to evaluate the new SIC criteria in patients diagnosed with sepsis 3.0. Data from patients diagnosed with sepsis 3.0 after ICU admission were retrospectively obtained from July 2013 to June 2014. Relevant demographic, clinical, and laboratory parameters were noted. This study included 252 patients. The International Society on Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC), modified ISTH-DIC, and SIC scores were higher among nonsurvivors (P < 0.0001). The Acute Physiology and Chronic Health Evaluation II (P < 0.001), ISTH (P = 0.001), modified ISTH (P = 0.001), and SIC scores (P = 0.007) were independent predictors of ICU mortality. Using the receiver operating characteristic curve, SOFA had the greatest power for predicting ICU mortality; ISTH or modified ISTH score had greater predictive power than the SIC score. There were strong correlations between SIC score and ISTH (P < 0.0001), modified ISTH (P < 0.0001), the Acute Physiology and Chronic Health Evaluation II (P = 0.012), and SOFA (P < 0.0001) scores. More nonsurvivors were diagnosed with DIC using the ISTH and modified ISTH criteria (P < 0.001). In contrast, there was no significant difference in the proportion of patients with SIC between both groups (P = 0.055). ISTH score, modified ISTH score, and SIC score were independent risk factors for ICU mortality. Compared with the ISTH and modified ISTH scores, SIC score showed no advantage in diagnosing sepsis-associated coagulopathy or DIC. The application of these three criteria in patients with sepsis 3.0 needs further evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of a new criteria for sepsis-induced coagulopathy and International Society on Thrombosis and Haemostasis disseminated intravascular coagulation score in critically ill patients with sepsis 3.0

Ding

Wang²,

Lin³

et al. 2018

Blood Coagulation &Amp; Fibrinolysis

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“…Interestingly, the clotting time measured in EXTEM was strongly correlated with the DIC score of the Japanese Association for Acute Medicine [17]. We assessed the differences in results between traumatized and septic DIC cases that were diagnosed by the same DIC scoring system [18]. This study found that the plasma fibrinogen level and clot firmness measured in the FIBTEM test were significantly different between groups with the same severity.…”

Section: Rotem Systemmentioning

confidence: 70%

Monitoring the coagulation status of trauma patients with viscoelastic devices

2017

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Coagulopathy is a physiological response to massive bleeding that frequently occurs after severe trauma and is an independent predictive factor for mortality. Therefore, it is very important to grasp the coagulation status of patients with severe trauma quickly and accurately in order to establish the therapeutic strategy. Judging from the description in the European guidelines, the importance of viscoelastic devices in understanding the disease condition of patients with traumatic coagulopathy has been widely recognized in Europe. In the USA, the ACS TQIP Massive Transfusion in Trauma Guidelines proposed by the American College of Surgeons in 2013 presented the test results obtained by the viscoelastic devices, TEG® 5000 and ROTEM®, as the standard for transfusion or injection of blood plasma, cryoprecipitate, platelet concentrate, or anti-fibrinolytic agents in the treatment strategy for traumatic coagulopathy and hemorrhagic shock. However, some studies have reported limitations of these viscoelastic devices. A review in the Cochrane Library published in 2015 pointed out the presence of biases in the abovementioned reports in trauma patients and the absence of a quality study in this field thus far. A quality study on the relationship between traumatic coagulopathy and viscoelastic devices is needed.

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“…Fibrinogen level was rapidly reduced than the other coagulation markers during the early phase of severe trauma. [ 27 , 28 ] In contrast, fibrinogen level was maintained at a moderate level in sepsis, [ 28 , 29 ] because trauma was characterized by a consumptive coagulopathy, unlike sepsis. In the present study, multivariate analysis revealed that fibrinogen level as a continuous variable was not an independent predictor of mortality.…”

Section: Discussionmentioning

confidence: 99%

Performance of 5 disseminated intravascular coagulation score systems in predicting mortality in patients with severe trauma

Lee

Lee²,

Jeung³

et al. 2018

Medicine

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The present study aimed to analyze and compare the prognostic performances of the Japanese Ministry of Health and Welfare (JMHW) score, the Korean Society on Thrombosis and Hemostasis (KSTH) score, the International Society on Thrombosis and Haemostasis (ISTH) score, the Japanese Association for Acute Medicine (JAAM) score, and the revised JAAM (rJAAM) score, for 28-day mortality in severe trauma.This retrospective observational study included patients admitted for severe trauma between 2012 and 2015. Receiver operating characteristics analysis was performed to examine the prognostic performance of the 5 different DIC score systems. The primary outcome was 28-day mortality following an injury.Of the 1266 patients included in the study, 28-day mortality rate was 19.7% (n = 249). The area under the curves (AUCs) of JMHW, KSTH, ISTH, JAAM, and rJAAM scores for 28-day mortality were 0.751 [95% confidence interval (95% CI), 0.726–0.775], 0.726 (95% CI, 0.701–0.750), 0.700 (95% CI, 0.674–0.725), 0.673 (95% CI, 0.646–0.699), and 0.676 (95% CI, 0.649–0.701), respectively. The AUC of JMHW score was significantly different from those of the other score systems. Fibrinogen levels ≤1.0 g/L [odds ratio (OR), 1.824; 95% CI, 1.029–3.232] and 1.0 to 1.5 g/L (OR, 1.697; 95% CI, 1.058–2.724) were independently associated with 28-day mortality compared with fibrinogen level above 1.5 g/L.JMHW score has the highest prognostic performance for 28-day mortality among DIC score systems in severe trauma. Fibrinogen level seemed to have a role in greater discrimination of JMHW scores than the other DIC score systems.

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The thromboelastometric discrepancy between septic and trauma induced disseminated intravascular coagulation diagnosed by the scoring system from the Japanese association for acute medicine

Cited by 11 publications

References 28 publications

Comparison of a new criteria for sepsis-induced coagulopathy and International Society on Thrombosis and Haemostasis disseminated intravascular coagulation score in critically ill patients with sepsis 3.0

Comparison of a new criteria for sepsis-induced coagulopathy and International Society on Thrombosis and Haemostasis disseminated intravascular coagulation score in critically ill patients with sepsis 3.0

Monitoring the coagulation status of trauma patients with viscoelastic devices

Performance of 5 disseminated intravascular coagulation score systems in predicting mortality in patients with severe trauma

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