Diagnosis of overt disseminated intravascular coagulation in critically Ill adults by Sonoclot coagulation analysis
| Autor: | Xingqin Zhang, You-qing Tang, Hua-sheng Tong, Peng Wan, Peng-Kai Duan, Lei Su |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Blood Platelets Male medicine.medical_specialty Whole Blood Coagulation Time Critical Illness Activated clotting time Fibrin Fibrinogen Degradation Products Internal medicine medicine Humans Platelet Aged Disseminated intravascular coagulation medicine.diagnostic_test Receiver operating characteristic business.industry Platelet Count Hematology Gold standard (test) Disseminated Intravascular Coagulation Middle Aged medicine.disease Thrombosis Surgery Coagulation ROC Curve Hemostasis Cardiology Female business |
| Zdroj: | International journal of hematology. 100(2) |
| ISSN: | 1865-3774 |
| Popis: | Disseminated intravascular coagulation (DIC) diagnosis is hampered by the limited availability of reliable clinical or laboratory tests. Currently available tests are time consuming and expensive. We investigated whether coagulation and platelet function analyses using the Sonoclot system were suitable for overt DIC diagnosis in critically ill adults. This was an observational diagnostic study performed in 498 patients presenting with an underlying disorder associated with DIC. Overt DIC patients were identified according to an International Society on Thrombosis and Hemostasis (ISTH) score of >5. Coagulation and platelet parameters were analyzed using the Sonoclot system, and compared with ISTH as the gold standard. Receiver operating characteristic curves and area under the curves were used to evaluate the value of the Sonoclot parameters. There were no differences for age or gender between the groups. Significant correlations were observed between activated clotting time (ACT) and ISTH score (r = 0.7; P < 0.001), clot rate (CR) and ISTH score (r = 0.5; P < 0.001), platelet function (PF) and ISTH score (r = -0.6; P < 0.001), and PF and platelet count (r = 0.5; P < 0.001). An ACT cut-off value of 213.5 s alone or combined with CR presented good sensitivity (76.7 and 86.8 %, respectively) and specificity (96.2 and 93.3 %, respectively). Sonoclot analysis can be performed using a point-of-care device that effectively discriminates low and high ISTH scores, and that effectively predicts coagulation dysfunction in patients with overt DIC. |
| Databáze: | OpenAIRE |
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