评估 ICU 脓毒症患者脓毒症相关性弥散性血管内凝血的两项简化修订标准的验证：一项回顾性研究。
Validation of Two Revised, Simplified Criteria for Assessing Sepsis-Associated Disseminated Intravascular Coagulation in ICU Patients with Sepsis-3: A Retrospective Study.
机构信息
Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Lab Med. 2023 May 2;54(3):291-298. doi: 10.1093/labmed/lmac112.
OBJECTIVE
This study aimed to validate the performance of modified Japanese Association for Acute Medicine (m-JAAM) and simplified Japanese Society on Thrombosis and Hemostasis (s-JSTH) criteria in diagnosing coagulation disorders in sepsis and examine their prognostic value compared with sepsis-induced coagulopathy (SIC) and International Society on Thrombosis and Hemostasis (ISTH) criteria.
METHODS
This retrospective study included subjects diagnosed with sepsis (August 2020 to February 2021, n = 296). The m-JAAM, s-JSTH, SIC, and ISTH criteria were evaluated and compared using receiver operating characteristic (ROC) curves and areas under the curve (AUCs).
RESULTS
There was no significant difference in AUC for predicting in-hospital 28-day mortality by m-JAAM, s-JSTH, SCI, and ISTH criteria (0.745, 0.763, 0.760, and 0.730, respectively). The proportion of patients fulfilling the m-JAAM and SIC criteria was higher than that of the s-JSTH and ISTH criteria (43.2%, 56.1% vs. 25.0%, 22.6%, P < .05).
CONCLUSION
The m-JAAM criteria might be more suitable for early-stage disseminated intravascular coagulation of sepsis than s-JSTH criteria.
目的
本研究旨在验证改良日本急救医学会（m-JAAM）和简化日本血栓与止血学会（s-JSTH）标准在诊断脓毒症凝血障碍方面的性能，并与脓毒症诱导的凝血障碍（SIC）和国际血栓与止血学会（ISTH）标准比较其预后价值。
方法
本回顾性研究纳入了 2020 年 8 月至 2021 年 2 月期间诊断为脓毒症的患者（n=296）。使用受试者工作特征（ROC）曲线和曲线下面积（AUCs）评估和比较 m-JAAM、s-JSTH、SIC 和 ISTH 标准。
结果
m-JAAM、s-JSTH、SIC 和 ISTH 标准预测院内 28 天死亡率的 AUC 无显著差异（分别为 0.745、0.763、0.760 和 0.730）。符合 m-JAAM 和 SIC 标准的患者比例高于 s-JSTH 和 ISTH 标准（43.2%、56.1% vs. 25.0%、22.6%，P<0.05）。
结论
m-JAAM 标准可能比 s-JSTH 标准更适用于脓毒症弥散性血管内凝血的早期阶段。
Zotero 插件