Prognostic significance of disseminated intravascular coagulation in patients with heat stroke in a nationwide registry

医学 弥漫性血管内凝血 内科学 优势比 置信区间 观察研究 冲程(发动机) 多元分析 单变量分析 重症监护医学 外科 机械工程 工程类
作者
Toru Hifumi,Yutaka Kondo,Junya Shimazaki,Yasutaka Oda,Shin‐ichiro Shiraishi,Masahiro Wakasugi,Jun Kanda,Takashi Moriya,Masaharu Yagi,Masaji Ono,Takashi Kawahara,Michihiko Tonouchi,Hiroyuki Yokota,Yasufumi Miyake,Keiki Shimizu
出处
期刊:Journal of Critical Care [Elsevier BV]
卷期号:44: 306-311 被引量:57
标识
DOI:10.1016/j.jcrc.2017.12.003
摘要

Heat stroke (HS) induces disseminated intravascular coagulation (DIC); however, the prognostic significance of DIC in patients with HS has not yet been fully assessed in large populations. The aim of this study was to examine the prognostic significance of DIC in patients with HS using a nationwide registry.Data regarding HS were obtained and analyzed from three prospective, observational, multicenter HS registries (HSRs): 2010, 2012, and 2014. Univariate and multivariate analyses were performed to identify independent predictors of hospital death. DIC was diagnosed according to the Japanese Association for Acute Medicine (JAAM) diagnostic criteria, with a total score≥4 implying a DIC diagnosis.In total, 705 (median age, 68years; 501 men) were included in this study. Hospital mortality was 7.1% (50 patients). Multiple regression analysis revealed that hospital mortality was significantly associated with presence of DIC (odds ratio [OR], 2.16; 95% confidence interval [CI], 1.09-4.27; p=0.028). Mortality worsened as the DIC score increased, and increased remarkably to approximately 10% when the DIC score was 2.Presence of DIC was an independent prognostic factor of hospital mortality in patients with HS. Hematological dysfunction represents potential target for specific therapies in HS.
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