Performance of 5 disseminated intravascular coagulation score systems in predicting mortality in patients with severe trauma.

Abstract:

:The present study aimed to analyze and compare the prognostic performances of the Japanese Ministry of Health and Welfare (JMHW) score, the Korean Society on Thrombosis and Hemostasis (KSTH) score, the International Society on Thrombosis and Haemostasis (ISTH) score, the Japanese Association for Acute Medicine (JAAM) score, and the revised JAAM (rJAAM) score, for 28-day mortality in severe trauma.This retrospective observational study included patients admitted for severe trauma between 2012 and 2015. Receiver operating characteristics analysis was performed to examine the prognostic performance of the 5 different DIC score systems. The primary outcome was 28-day mortality following an injury.Of the 1266 patients included in the study, 28-day mortality rate was 19.7% (n = 249). The area under the curves (AUCs) of JMHW, KSTH, ISTH, JAAM, and rJAAM scores for 28-day mortality were 0.751 [95% confidence interval (95% CI), 0.726-0.775], 0.726 (95% CI, 0.701-0.750), 0.700 (95% CI, 0.674-0.725), 0.673 (95% CI, 0.646-0.699), and 0.676 (95% CI, 0.649-0.701), respectively. The AUC of JMHW score was significantly different from those of the other score systems. Fibrinogen levels ≤1.0 g/L [odds ratio (OR), 1.824; 95% CI, 1.029-3.232] and 1.0 to 1.5 g/L (OR, 1.697; 95% CI, 1.058-2.724) were independently associated with 28-day mortality compared with fibrinogen level above 1.5 g/L.JMHW score has the highest prognostic performance for 28-day mortality among DIC score systems in severe trauma. Fibrinogen level seemed to have a role in greater discrimination of JMHW scores than the other DIC score systems.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Lee DH,Lee BK,Jeung KW,Park JS,Lim YD,Jung YH,Lee SM,Cho YS

doi

10.1097/MD.0000000000011912

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

e11912

issue

33

eissn

0025-7974

issn

1536-5964

pii

00005792-201808170-00041

journal_volume

97

pub_type

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