Abstract Number: PB0450
Meeting: ISTH 2021 Congress
Background: DIC is one of the most common complicated conditions in medical practice. The International Society of Thrombosis and Haemostasis (ISTH) DIC scoring system was developed to guide in diagnosis of DIC. However, there was no study in Thailand about the prognostic values of this scoring system when comparing to general practice in prediction of mortality.
Aims: To compare the diagnosis of DIC by using ISTH DIC scoring system and general practice to predict 28-day mortality in terms of sensitivity, specificity and accuracy.
Methods: The prospective cohort study was conducted. 150 inpatients complicated with clinical suspicious of DIC were enrolled. The diagnosis of DIC by general practice was performed by hematologists in Phramongkutklao Hospital. DIC score was calculated for each patient by using ISTH scoring system. The sensitivity, specificity, accuracy and survival analysis of the patients were evaluated.
Results: In prediction of 28-day mortality, ISTH DIC scoring system had a better specificity and accuracy when comparing to general practice; 68.7% and 61.3% (p-value = 0.183); 72.0% and 52.0% (p-value = 0.004), respectively. However, the sensitivity of general practice was better; 80.0% and 62.0% (p-value = 0.047). Survival analyses by using DIC scoring system showed that patients with overt-DIC group had a statistically significant lower rate of survival at 28 days when comparing to non-overt DIC group; 55.88% and 73.53% (p-value = 0.002). However, by using general practice method, the rate of survival at 28 days in patients with DIC group was not significantly different from non-DIC group; 63.97% and 66.91% (p-value = 0.064). (Figure 1).
Conclusions: The diagnosis of DIC by ISTH DIC scoring system had better accuracy and specificity in prediction of 28-day mortality, however, it had less sensitivity when comparing to general practice. In addition, ISTH DIC score could have a better power of discrimination between survivors and non-survivors in patients with DIC.
To cite this abstract in AMA style:Thamgrang T, Sirisuksakun C, Prayongratana K. A Prospective Comparison Study of the Diagnosis of Disseminated Intravascular Coagulation (DIC) Comparing Between ISTH DIC Scoring system and General Practice in Prediction of 28-day Mortality [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/a-prospective-comparison-study-of-the-diagnosis-of-disseminated-intravascular-coagulation-dic-comparing-between-isth-dic-scoring-system-and-general-practice-in-prediction-of-28-day-mortality/. Accessed September 24, 2021.
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