Abstract Number: OC 45.3
Meeting: ISTH 2021 Congress
Background: The Model of End-Stage Liver Disease (MELD)-Na score is widely used to assess patients waiting for a liver transplant. It has, however, been criticized for underestimating mortality in certain populations.
Aims: In this study we investigated whether coagulopathy as measured by the International Society on Thrombosis and Haemostasis (ISTH) Disseminated Intravascular Coagulation (DIC) score is able to predict 90-day mortality independently of the MELD-Na score in patients with liver insufficiency.
Methods: We retrospectively analyzed all patients admitted to the General Hospital of Vienna from 2003-2014 with a fibrinogen level <150 mg/dL, liver disease in their medical history and ≥2 pathological DIC-parameters. We used a Cox regression and Receiver Operating Characteristic (ROC) analysis to assess the predictive value of the ISTH-DIC score in its original (DIC-2001) and revised form (DIC 2018).
Results: Out of 1333 patients screened, 388 patients (38% female, median age 58 years, IQR 48-66 years) were analyzed. The DIC-2001 score (HR 2.08, 95%-CI 1.74 – 2.49, p<0.001) and DIC-2018 score (HR 1.73, 95%-CI 1.50 – 1.99, p<0.001) predicted 90-day mortality independently of the MELD-Na score. The areas under the curves (AUC) of the DIC-2001 and DIC-2018 score were greater than the AUC of the MELD-Na score (0.75 vs. 0.65, p=0.004 and 0.74 vs. 0.65, p=0.011, respectively, Figure 1).
Conclusions: The ISTH DIC-2001 and DIC-2018 scores predicted 90-day mortality independently of the MELD-Na score in patients with liver insufficiency. The DIC score deserves further investigation in this population as it likely reflects different dimensions of the underlying disease.
To cite this abstract in AMA style:Grafeneder J, Buchtele N, Egger D, Schwameis M, Ay C, Jilma B, Schörgenhofer C. Overt DIC Score Predicts Mortality in Liver Insufficiency, a Comparison with the MELD-Na Score [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/overt-dic-score-predicts-mortality-in-liver-insufficiency-a-comparison-with-the-meld-na-score/. Accessed December 3, 2021.
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