Disseminated intravascular coagulation (DIC) diagnosed based on the Japanese Association for Acute Medicine criteria is a dependent continuum to overt DIC in patients with sepsis

Introduction: Sepsis is the most common disease associated with disseminated intravascular coagulation (DIC). To test the hypothesis that DIC diagnosed by the Japanese Association for Acute Medicine (JAAM) DIC scoring system (JAAM DIC) constitutes a dependent continuum to overt DIC diagnosed by the International Society on Thrombosis and Haemostasis (ISTH) overt DIC scoring system (ISTH overt DIC) in patients with sepsis, we conducted a retrospective study. Materials and Methods: The databases from two prospective, multicenter clinical investigations were analyzed. The inclusion criteria comprised patients with sepsis-related DIC, who met the JAAM DIC criteria. Results: The present study enrolled 166 patients, of whom 67 met the ISTH overt DIC criteria. All patients with sepsis who developed to overt DIC during the study period could be identified by the JAAM DIC diagnostic criteria in the first study. While the overall 28-day mortality was 31.3%, mortality (40.3%, p=0.0040) and the incidence of multiple organ dysfunction syndrome (70.1%, p=0.008) of the patients with the ISTH overt DIC was approximately one and a half times that of the patients associated with only the JAAM DIC. A stepwise increase in the ISTH overt DIC scores and the incidence of the ISTH overt DIC were also observed in accordance with the increase in the JAAM DIC scores. Conclusion: DIC diagnosed based on the JAAM DIC diagnostic criteria exists in a dependent continuum to the ISTH overt DIC in patients with sepsis, thus enabling them to receive early treatment. (C) 2008 Elsevier Ltd. All rights reserved.