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Hypofibrinogenemia Is a High Risk for Infectious Type of Disseminated Intravascular Coagulation

1Mie Prefectural General Medical Center, General Medicine, Yokkaichi, Japan, 2Asahi Kasei Pharma Corporation, Tokyo, Japan, 3Miyazaki Prefectural Miyazaki Hospital, Miyazaki, Japan, 4National Hospital Organization Takasaki General Medical Center, Takasaki, Japan, 5Faculty of Medical Technology, Teikyo University, Tokyo, Japan, 6Tokyo Saiseikai Central Hospital, Tokyo, Japan, 7National Hospital Organization Disaster Medical Center, Tokyo, Japan, 8Mie University Hospital, Tsu, Japan, 9Uonuma Institute of Community Medicine, Niigata, Japan, 10Fukushima Medical University, Fukushima, Japan, 11Juntendo University, Tokyo, Japan, 12Kitakyushu City Yahata Hospital, Kitakyushu, Japan

Abstract Number: PB0803

Meeting: ISTH 2020 Congress

Theme: Hemophilia and Rare Bleeding Disorders » Disseminated Intravascular Coagulation

Background: Disseminated intravascular coagulation (DIC) is classified into hematopoietic injury, infectious or basic types in the Japanese Society of Thrombosis Hemostasis.

Aims: We examined the relationship between hypofibrinogenemia and pathophysiology in infectious DIC.

Methods: We analyzed 3663 patients who were treated with thrombomodulin-α (TM-α) as a post-marketing survey for TM-α in DIC. Patients with fibrinogen < 1.5g/L were considered to have a hypofibrinogenemia.

Results: Hypofibrinogenemia was observed in 10.3% in infectious type of DIC, 27.8% in hematopoietic injury type of DIC and 25.7% in basic type of DIC. The frequency of both bleeding and organ failure symptoms, and the scores of organ failure or DIC diagnostic criteria were significantly higher in infectious type of DIC patients with hypofibrinogemia than in those without hypofibrinogemia, suggesting that a hypofibrinogenemia in infectious type DIC is more progressive and severe DIC.
Although a 28-days survival and resolution rate of DIC were significantly lower in only infectious type DIC with hypofibrinogenemia than those without, there were no significant difference in a 28-days survival and resolution rate of DIC between both groups of hematopoietic and basic type DIC. The mechanism of hypofibrinogenemia may be different in infectious type DIC from hematopoietic injury type DIC.

Conclusions: The hypofibrinogemia in infectious type of DIC is progressive and severe DIC and is frequently associate with bleeding and multiple organ failure, suggesting that the monitoring the fibrinogen level is important for management of infectious type of DIC.

To cite this abstract in AMA style:

Wada H, Honda G, Kawano N, Uchiyama T, Kawasugi K, Madoiwa S, Takezako N, Suzuki K, Seki Y, Ikezoe T, Iba T, Okamoto K. Hypofibrinogenemia Is a High Risk for Infectious Type of Disseminated Intravascular Coagulation [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/hypofibrinogenemia-is-a-high-risk-for-infectious-type-of-disseminated-intravascular-coagulation/. Accessed May 16, 2021.

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