Net reclassification index in comparison of prognostic value of disseminated intravascular coagulation diagnostic criteria by Japanese Society on Thrombosis and Hemostasis and International Society on Thrombosis and Haemostasis: a multicenter prospective cohort study

Thrombosis Journal

Research

Mineji Hayakawa¹  Hiroyasu Ishikura²  Yuhei Irie²  Kazuma Yamakawa³  Noritaka Yada⁴  Kenji Nishio⁴  Kayo Harada-Shirado⁵  Takayuki Ikezoe⁵  Hirotaka Mori⁵  Noriaki Kawano⁶  Yoshinobu Seki⁷  Toshimasa Uchiyama⁸  Kohji Okamoto⁹ 

[1] Department of Emergency Medicine, Hokkaido University Hospital, N14W5, Kita-ku, 060-8648, Sapporo, Hokkaido, Japan;Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma Jonan-ku, 814-0180, Fukuoka, Fukuoka, Japan;Department of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-machi, 569-8686, Takatsuki, Osaka, Japan;Department of General Medicine, Nara Medical University, 840 Shijo-cho, 634-8522, Kashihara, Nara, Japan;Department of Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Fukushima, Fukushima, Japan;Department of Hematology, Miyazaki Prefectural Miyazaki Hospital, 5-30 Kita Takamatsu- machi, 880-8510, Miyazaki, Miyazaki, Japan;Department of Hematology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 4132, 949-7302, Urasa, Minamiuonuma-shi, Niigata, Japan;Department of Laboratory Medicine, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, 370-0829, Takasaki, Gunma, Japan;Department of Surgery, Kitakyushu City Yahata Hospital, 2-6-2 Ogura Yahatahigashi-ku, 805-8534, Kitakyushu, Fukuoka, Japan;

关键词: Disseminated intravascular coagulation;    Diagnosis criteria;    Prognosis;    Mortality;    Net reclassification improvement;   

DOI  :  10.1186/s12959-023-00523-1

 received in 2023-01-10, accepted in 2023-07-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWe compared the prognostic value of the Japanese Society on Thrombosis and Hemostasis (JSTH) disseminated intravascular coagulation (DIC) diagnostic criteria with that of the International Society on Thrombosis and Haemostasis (ISTH) DIC diagnostic criteria for 28-day in-hospital mortality.MethodsWe conducted a multicenter prospective cohort study involving two hematology departments, four emergency departments, and one general medicine department in Japan between August 2017 and July 2021. We assessed three ISTH DIC diagnostic criteria categories using low cutoff levels of D-dimer (low D-dimer), high cutoff levels of D-dimer (high D-dimer), and fibrinogen/fibrin degradation products (FDP) as fibrin-related markers. The main outcome was diagnosis-based category additive net reclassification index (NRI).ResultsA total of 222 patients were included: 82 with hematopoietic disorders, 86 with infections, and 54 with other diseases. The 28-day in-hospital mortality rate was 14% (n = 31). The DIC rates diagnosed by the JSTH, ISTH-low D-dimer, high D-dimer, and FDP DIC diagnosis were 52.7%, 47.3%, 42.8%, and 27.0%, respectively. The overall category additive NRI by JSTH DIC diagnosis vs. ISTH-low D-dimer, high D-dimer, and FDP DIC diagnosis were − 10 (95% confidence interval [CI]: −28 to 8, p = 0.282), − 7.8 (95% CI: −26 to 10, p = 0.401), and − 11 (95% CI: −26 to 3, p = 0.131), respectively.ConclusionsJSTH criterion showed the highest sensitivity for DIC diagnosis that did not improve but reflected the same prognostic value for mortality evaluated using ISTH DIC diagnosis criteria. This finding may help clinicians to use JSTH DIC criterion as an early intervention strategy in patients with coagulopathy.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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