三种不同DIC评分对脓毒性休克器官功能损伤和预后评估的应用价值

doi:10.3969/j.issn.1002-1949.2019.02.014

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (2): 170-174 DOI: 10.3969/j.issn.1002-1949.2019.02.014

Evaluation of ISTH, JAAM and CDICS for predicting organ dysfunction and mortality in septic shock

Chen Xiao-ying, Zhang Yan, Zhang Dan

SICU of Critical Care Medicine Department, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

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Abstract Objective To investigate the value of three DIC scores：The International Society of Thrombisis and Hemostasis(ISTH), Japanese Association for Acate Medicin(JAAM) and Cheinese disseminated intravascular coagulation scoring(CDICS) in assessing organ dysfunction and prognosis in septic shock. Methods This retrospective, observational study recruited 96 septic shock patients admitted to our ICU. The patients diagnosed from three criteria (ISTH score, JAAM score, and CDICS score) were classified into DIC and NODIC groups. Clinical data and 28-day mortality were compared. Results ①There was significant difference in ISTH scores between survival and death groups ［3(2,5) vs 4(3,6)］, respectively, P=0.049］, but no difference in JAAM scores and CDICS scores. ②There was weak correlation between ISTH/JAAM/CDICS score and APACHE Ⅱor SOFA score, r values were 0.335, 0.434, 0.444 (vs APACHE Ⅱ) and 0.443, 0.559, 0.632 (vs SOFA); ③There was no difference in the 28-day mortality between the DIC group and NODIC group, but APACHE Ⅱ score and SOFA score of DIC group were significantly higher than NODIC group (P<0.05); ④ROC curve analysis showed that the AUC area of the three different DIC scores predicted 28-day mortality in septic shock were 0.626, 0.578, and 0.613, respectively. Conclusion Three different DIC scores (ISTH score, JAAM score, CDICS score) are helpful in assessing organ dysfunction and severity in septic shock, but useless to assess of 28-day mortality.

Key words： Septic shock Disseminated intravascular coagulation (DIC) DIC score Prognosis

Corresponding Authors: Zhang Dan, E-mail: doctor-zhangdan@126.com

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Chen Xiao-ying,Zhang Yan,Zhang Dan. Evaluation of ISTH, JAAM and CDICS for predicting organ dysfunction and mortality in septic shock[J]. Chinese Journal of Critical Care Medicine, 2019, 39(2): 170-174.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2019.02.014 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I2/170

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