| アブストラクト | BACKGROUND: Disseminated intravascular coagulation (DIC) is characterized by systemic activation of coagulation pathways within the microvasculature, ultimately resulting in multiorgan dysfunction. The International Society on Thrombosis and Haemostasis (ISTH) subcommittee has recently introduced the 2025 overt DIC scoring system for clinical diagnosis. OBJECTIVES: This study aimed to evaluate the clinical relevance of the 2025 ISTH overt DIC scoring system and its proposed cutoff values for the mortality risk assessment in patients with diverse underlying diseases. METHODS: Patient data were extracted from the Japan Medical Data Center database, focusing on individuals diagnosed with sepsis, hematopoietic neoplasms, or solid cancers. Patients were included only if baseline levels of fibrinogen, platelets, prothrombin time (PT), and fibrin-related markers were available on the day of admission. Restricted cubic spline models were applied to evaluate nonlinear associations between coagulation parameters and in-hospital death. RESULTS: Data from 8181 patients with sepsis, 7548 patients with hematopoietic neoplasms, and 11 614 with solid cancers revealed a marked increase in mortality associated with fibrinogen < 2 g/L, platelets < 100 x 10(9)/L, PT >14 seconds, and D-dimer > 3 mg/L. Among these, PT prolongation and elevated D-dimer demonstrated the strongest associations with mortality. Across all 3 disease groups, in-hospital mortality showed a consistent positive correlation with the ISTH DIC sum score. CONCLUSION: These findings support the prognostic utility of the 2025 ISTH overt DIC scoring system and its proposed cutoff values in evaluating mortality risk among patients with sepsis, hematopoietic malignancies, and solid cancers. |
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| ジャーナル名 | Journal of thrombosis and haemostasis : JTH |
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| Pubmed追加日 | 2025/11/3 |
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| 投稿者 | Shinkai, Akane; Ito, Takashi; Hashiguchi, Ema; Katsuno, Michiko; Umemura, Yutaka; Yamakawa, Kazuma; Okamoto, Kohji |
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| 組織名 | Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan.;Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan; School;of Health Sciences, Kumamoto University, Kumamoto, Japan; Department of;Hematology and Immunology, Faculty of Life Science, Kumamoto University,;Kumamoto, Japan. Electronic address: tito@kumamoto-u.ac.jp.;School of Health Sciences, Kumamoto University, Kumamoto, Japan.;Department of Traumatology and Acute Critical Medicine, Osaka University Graduate;School of Medicine, Osaka, Japan.;Department of Emergency and Critical Care Medicine, Osaka Medical and;Pharmaceutical University, Takatsuki, Japan.;Department of Surgery, Kitakyushu City Yahata Hospital, Fukuoka, Japan.;The Japanese Society on Thrombosis and Hemostasis, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41177457/ |
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