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Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study

There is no gold standard for the diagnosis of coagulation dysfunction in sepsis, and the use of the current scoring systems is still controversial. The purpose of this study was to assess the performance of sepsis-induced coagulopathy (SIC), the Japanese Association for Acute Medicine Disseminated...

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Autores principales: Chen, Yuwei, Chen, Weiwei, Ba, Fuhua, Zheng, Yanjun, Zhou, Yi, Shi, Wen, Li, Jian, Yang, Zhitao, Mao, Enqiang, Chen, Erzhen, Chen, Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623916/
https://www.ncbi.nlm.nih.gov/pubmed/37920943
http://dx.doi.org/10.1177/10760296231207630
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author Chen, Yuwei
Chen, Weiwei
Ba, Fuhua
Zheng, Yanjun
Zhou, Yi
Shi, Wen
Li, Jian
Yang, Zhitao
Mao, Enqiang
Chen, Erzhen
Chen, Ying
author_facet Chen, Yuwei
Chen, Weiwei
Ba, Fuhua
Zheng, Yanjun
Zhou, Yi
Shi, Wen
Li, Jian
Yang, Zhitao
Mao, Enqiang
Chen, Erzhen
Chen, Ying
author_sort Chen, Yuwei
collection PubMed
description There is no gold standard for the diagnosis of coagulation dysfunction in sepsis, and the use of the current scoring systems is still controversial. The purpose of this study was to assess the performance of sepsis-induced coagulopathy (SIC), the Japanese Association for Acute Medicine Disseminated Intravascular Coagulation (JAAM DIC), and the International Society on Thrombosis and Haemostasis overt DIC (ISTH overt-DIC). The relationship between each scoring system and 28-day all-cause mortality was examined. Among 452 patients (mean age, 65 [48,76] years), 306 [66.7%] were men, the median SOFA score was 6 [4,9], and the median APACHE II score was 15 [11,22]. A total of 132 patients (29.2%) died within 28 days. Both the diagnosis of SIC (AUROC, 0.779 [95% CI, 0.728–0.830], P < 0.001) and ISTH overt-DIC (AUROC, 0.782 [95% CI, 0.732–0.833], P < 0.001) performed equally well in the discrimination of 28-day all-cause mortality (between-group difference: SIC versus ISTH overt-DIC, −0.003 [95% CI, −0.025–0.018], P = 0.766). However, the SIC demonstrated greater calibration for 28-day all-cause mortality than ISTH overt-DIC (the coincidence of the calibration curve of the former is higher than that of the latter). The diagnosis of JAAM DIC was not independently associated with 28-day all-cause mortality in sepsis (RR, 1.115, [95% CI 0.660–1.182], P = 0.684). The SIC scoring system demonstrated superior prognostic prediction ability in comparison with the others and is the most appropriate standard for diagnosing coagulopathy in sepsis.
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spelling pubmed-106239162023-11-04 Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study Chen, Yuwei Chen, Weiwei Ba, Fuhua Zheng, Yanjun Zhou, Yi Shi, Wen Li, Jian Yang, Zhitao Mao, Enqiang Chen, Erzhen Chen, Ying Clin Appl Thromb Hemost Original Manuscript There is no gold standard for the diagnosis of coagulation dysfunction in sepsis, and the use of the current scoring systems is still controversial. The purpose of this study was to assess the performance of sepsis-induced coagulopathy (SIC), the Japanese Association for Acute Medicine Disseminated Intravascular Coagulation (JAAM DIC), and the International Society on Thrombosis and Haemostasis overt DIC (ISTH overt-DIC). The relationship between each scoring system and 28-day all-cause mortality was examined. Among 452 patients (mean age, 65 [48,76] years), 306 [66.7%] were men, the median SOFA score was 6 [4,9], and the median APACHE II score was 15 [11,22]. A total of 132 patients (29.2%) died within 28 days. Both the diagnosis of SIC (AUROC, 0.779 [95% CI, 0.728–0.830], P < 0.001) and ISTH overt-DIC (AUROC, 0.782 [95% CI, 0.732–0.833], P < 0.001) performed equally well in the discrimination of 28-day all-cause mortality (between-group difference: SIC versus ISTH overt-DIC, −0.003 [95% CI, −0.025–0.018], P = 0.766). However, the SIC demonstrated greater calibration for 28-day all-cause mortality than ISTH overt-DIC (the coincidence of the calibration curve of the former is higher than that of the latter). The diagnosis of JAAM DIC was not independently associated with 28-day all-cause mortality in sepsis (RR, 1.115, [95% CI 0.660–1.182], P = 0.684). The SIC scoring system demonstrated superior prognostic prediction ability in comparison with the others and is the most appropriate standard for diagnosing coagulopathy in sepsis. SAGE Publications 2023-11-03 /pmc/articles/PMC10623916/ /pubmed/37920943 http://dx.doi.org/10.1177/10760296231207630 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Manuscript
Chen, Yuwei
Chen, Weiwei
Ba, Fuhua
Zheng, Yanjun
Zhou, Yi
Shi, Wen
Li, Jian
Yang, Zhitao
Mao, Enqiang
Chen, Erzhen
Chen, Ying
Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study
title Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study
title_full Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study
title_fullStr Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study
title_full_unstemmed Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study
title_short Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study
title_sort prognostic accuracy of the different scoring systems for assessing coagulopathy in sepsis: a retrospective study
topic Original Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623916/
https://www.ncbi.nlm.nih.gov/pubmed/37920943
http://dx.doi.org/10.1177/10760296231207630
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