Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China
Abstract We aimed to determine disseminated intravascular coagulation (DIC)-associated organ failure and underlying diseases based on data from three ICU wards in tertiary hospitals in China from 2008 to 2016. The diagnosis of DIC was confirmed by an International Society of Thrombosis and Hemostasi...
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| Format: | Article |
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Nature Portfolio
2021-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-95841-7 |
| _version_ | 1828970226316738560 |
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| author | Zhiling Zhao Jianxin Zhang Nan Li Gaiqi Yao Yangyu Zhao Shuangling Li Qinggang Ge Junli Lu Shining Bo Jingjing Xi Yue Han |
| author_facet | Zhiling Zhao Jianxin Zhang Nan Li Gaiqi Yao Yangyu Zhao Shuangling Li Qinggang Ge Junli Lu Shining Bo Jingjing Xi Yue Han |
| author_sort | Zhiling Zhao |
| collection | DOAJ |
| description | Abstract We aimed to determine disseminated intravascular coagulation (DIC)-associated organ failure and underlying diseases based on data from three ICU wards in tertiary hospitals in China from 2008 to 2016. The diagnosis of DIC was confirmed by an International Society of Thrombosis and Hemostasis score greater than or equal to 5. The maternal outcomes included the changes in organ function 24 h after ICU admission. The durations of hospital stay and ICU stay were recorded as secondary outcomes. Among 297 ICU admissions (median Sequential Organ Failure Assessment score, 4) for obstetric diseases, there were 87 DIC cases, with an estimated DIC incidence of 87 per 87,580 deliveries. Postpartum hemorrhage was the leading disease associated with DIC (71, 81.6%), followed by hypertensive disorders (27, 31.0%), sepsis (15, 17.2%), acute fatty liver of pregnancy (11, 12.6%) and amniotic fluid embolism (10, 11.5%). Compared with patients without DIC, those with DIC had higher rates of multiple organ dysfunction syndrome/death (27.6% vs 4.8%, p = 0.000), organ failure (36.8% vs 24.3%, p = 0.029), among which organ failure included acute renal failure (32.2% vs 10.0%, p = 0.000), respiratory failure (16.1% vs 8.6%, p = 0.057), disturbance of consciousness (12.6% vs 2.4%, p = 0.000) and DIC group also had higher rates of massive transfusion (52.9% vs 21.9%, p = 0.000), hysterectomy (32.2% vs 15.7%, p = 0.001), longer ICU (4 days vs 2 days, p = 0.000) and hospital stays (14 days vs 11 days, p = 0.005). DIC and amniotic fluid embolism were independent risk factors for organ failure in patients admitted to the ICU. Postpartum hemorrhage was the leading cause of DIC associated organ failure in obstetrics admitted to the ICU. The control of obstetric bleeding in a timely manner may improve obstetric prognoses. |
| first_indexed | 2024-12-14T12:47:40Z |
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| id | doaj.art-71b9dd77c42c4db6aa93d5b02342aaad |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T12:47:40Z |
| publishDate | 2021-08-01 |
| publisher | Nature Portfolio |
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| spelling | doaj.art-71b9dd77c42c4db6aa93d5b02342aaad2022-12-21T23:00:45ZengNature PortfolioScientific Reports2045-23222021-08-011111710.1038/s41598-021-95841-7Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in ChinaZhiling Zhao0Jianxin Zhang1Nan Li2Gaiqi Yao3Yangyu Zhao4Shuangling Li5Qinggang Ge6Junli Lu7Shining Bo8Jingjing Xi9Yue Han10Department of Intensive Care Unit, Peking University Third HospitalDepartment of Gynecology and Obstetrics, Capital Medical University Affiliated Beijing Chao-Yang HospitalDepartment of Research Center of Clinical Epidemiology, Peking University Third HospitalDepartment of Intensive Care Unit, Peking University Third HospitalDepartment of Gynecology and Obstetrics, Peking University Third HospitalDepartment of Surgical Intensive Care Unit, Peking University First HospitalDepartment of Intensive Care Unit, Peking University Third HospitalDepartment of Gynecology and Obstetrics, Capital Medical University Affiliated Beijing Chao-Yang HospitalDepartment of Intensive Care Unit, Peking University Third HospitalDepartment of Intensive Care Unit, Peking University Third HospitalDepartment of Intensive Care Unit, Capital Medical University Affiliated Beijing Chao-Yang HospitalAbstract We aimed to determine disseminated intravascular coagulation (DIC)-associated organ failure and underlying diseases based on data from three ICU wards in tertiary hospitals in China from 2008 to 2016. The diagnosis of DIC was confirmed by an International Society of Thrombosis and Hemostasis score greater than or equal to 5. The maternal outcomes included the changes in organ function 24 h after ICU admission. The durations of hospital stay and ICU stay were recorded as secondary outcomes. Among 297 ICU admissions (median Sequential Organ Failure Assessment score, 4) for obstetric diseases, there were 87 DIC cases, with an estimated DIC incidence of 87 per 87,580 deliveries. Postpartum hemorrhage was the leading disease associated with DIC (71, 81.6%), followed by hypertensive disorders (27, 31.0%), sepsis (15, 17.2%), acute fatty liver of pregnancy (11, 12.6%) and amniotic fluid embolism (10, 11.5%). Compared with patients without DIC, those with DIC had higher rates of multiple organ dysfunction syndrome/death (27.6% vs 4.8%, p = 0.000), organ failure (36.8% vs 24.3%, p = 0.029), among which organ failure included acute renal failure (32.2% vs 10.0%, p = 0.000), respiratory failure (16.1% vs 8.6%, p = 0.057), disturbance of consciousness (12.6% vs 2.4%, p = 0.000) and DIC group also had higher rates of massive transfusion (52.9% vs 21.9%, p = 0.000), hysterectomy (32.2% vs 15.7%, p = 0.001), longer ICU (4 days vs 2 days, p = 0.000) and hospital stays (14 days vs 11 days, p = 0.005). DIC and amniotic fluid embolism were independent risk factors for organ failure in patients admitted to the ICU. Postpartum hemorrhage was the leading cause of DIC associated organ failure in obstetrics admitted to the ICU. The control of obstetric bleeding in a timely manner may improve obstetric prognoses.https://doi.org/10.1038/s41598-021-95841-7 |
| spellingShingle | Zhiling Zhao Jianxin Zhang Nan Li Gaiqi Yao Yangyu Zhao Shuangling Li Qinggang Ge Junli Lu Shining Bo Jingjing Xi Yue Han Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China Scientific Reports |
| title | Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China |
| title_full | Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China |
| title_fullStr | Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China |
| title_full_unstemmed | Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China |
| title_short | Disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units: a multicenter study in China |
| title_sort | disseminated intravascular coagulation associated organ failure in obstetric patients admitted to intensive care units a multicenter study in china |
| url | https://doi.org/10.1038/s41598-021-95841-7 |
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