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...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2023-11-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296231207630 |
| _version_ | 1827773048590172160 |
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| author | Yuwei Chen MMed Weiwei Chen MD Fuhua Ba MMed Yanjun Zheng MD Yi Zhou MMed Wen Shi MMed Jian Li PhD Zhitao Yang MD Enqiang Mao MD Erzhen Chen MD Ying Chen MD |
| author_facet | Yuwei Chen MMed Weiwei Chen MD Fuhua Ba MMed Yanjun Zheng MD Yi Zhou MMed Wen Shi MMed Jian Li PhD Zhitao Yang MD Enqiang Mao MD Erzhen Chen MD Ying Chen MD |
| author_sort | Yuwei Chen MMed |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-03-11T13:16:29Z |
| format | Article |
| id | doaj.art-56ea448bcbc14222b7b5832cbb785a8e |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-03-11T13:16:29Z |
| publishDate | 2023-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-56ea448bcbc14222b7b5832cbb785a8e2023-11-03T11:03:19ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232023-11-012910.1177/10760296231207630Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective StudyYuwei Chen MMed0Weiwei Chen MD1Fuhua Ba MMed2Yanjun Zheng MD3Yi Zhou MMed4Wen Shi MMed5Jian Li PhD6Zhitao Yang MD7Enqiang Mao MD8Erzhen Chen MD9Ying Chen MD10 Department of Emergency, the First Hospital of Handan, Handan, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Clinical Research Center, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, China Department of Emergency, , Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaThere 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.https://doi.org/10.1177/10760296231207630 |
| spellingShingle | Yuwei Chen MMed Weiwei Chen MD Fuhua Ba MMed Yanjun Zheng MD Yi Zhou MMed Wen Shi MMed Jian Li PhD Zhitao Yang MD Enqiang Mao MD Erzhen Chen MD Ying Chen MD Prognostic Accuracy of the Different Scoring Systems for Assessing Coagulopathy in Sepsis: A Retrospective Study Clinical and Applied Thrombosis/Hemostasis |
| 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 |
| url | https://doi.org/10.1177/10760296231207630 |
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