• Yoshinobu Seki, Hideo Wada, Kazuo Kawasugi, Kohji Okamoto, Toshimasa Uchiyama, Shigeki Kushimoto, Tsuyoshi Hatada, Takashi Matsumoto, Hiroshi Imai, and Japanese Society of Thrombosis Hemostasis/DIC Subcommittee.
• Department of Internal Medicine, Shibata Hospital-Niigata Prefectural Hospital, Japan.
• Intern. Med. 2013 Jan 1;52(17):1893-8.

ObjectiveDisseminated intravascular coagulation (DIC) is often associated with infection and a poor outcome. In this study, useful markers for predicting poor outcomes were examined.MethodsThe frequency of DIC and organ failure, outcomes and hemostatic markers were prospectively evaluated in 242 patients with infections.ResultsSeventy-seven patients were diagnosed with DIC, 36 of whom recovered from the condition. The rate of DIC or resolution of DIC was highest in the patients with sepsis and lowest in the patients with respiratory infections. Mortality tended to be high in the patients with respiratory infections. The DIC score, sepsis-related organ failure assessment (SOFA) score, prothrombin time (PT) ratio and thrombin-antithrombin complex level were significantly high in the patients who did not recover from DIC. The age, DIC score, SOFA score, PT ratio and levels of thrombomodulin and plasminogen activator inhibitor (PAI)-I were significantly high in the non-survivors. Factors related to a poor outcome included resolution of DIC, the SOFA score, age and the PT ratio. Factors related to resolution of DIC included the SOFA score and age, while factors related to the SOFA score included the levels of PAI-I, leukocytes, fibrinogen, D-dimer and platelets.ConclusionThe outcomes of septic patients primarily depend on the SOFA score and the resolution of DIC, which are related to organ failure.

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