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Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients

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Title: Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients
Authors: Wada, Takeshi Browse this author →KAKEN DB
Shiraishi, Atsushi Browse this author
Gando, Satoshi Browse this author
Yamakawa, Kazuma Browse this author
Fujishima, Seitaro Browse this author
Saitoh, Daizoh Browse this author
Kushimoto, Shigeki Browse this author
Ogura, Hiroshi Browse this author
Abe, Toshikazu Browse this author
Mayumi, Toshihiko Browse this author
Sasaki, Junichi Browse this author
Kotani, Joji Browse this author
Takeyama, Naoshi Browse this author
Tsuruta, Ryosuke Browse this author
Takuma, Kiyotsugu Browse this author
Yamashita, Norio Browse this author
Shiraishi, Shin-ichiro Browse this author
Ikeda, Hiroto Browse this author
Shiino, Yasukazu Browse this author
Tarui, Takehiko Browse this author
Nakada, Taka-aki Browse this author
Hifumi, Toru Browse this author
Okamoto, Kohji Browse this author
Sakamoto, Yuichiro Browse this author
Hagiwara, Akiyoshi Browse this author
Masuno, Tomohiko Browse this author
Ueyama, Masashi Browse this author
Fujimi, Satoshi Browse this author
Umemura, Yutaka Browse this author
Otomo, Yasuhiro Browse this author
Issue Date: 26-May-2021
Publisher: Nature Research
Journal Title: Scientific reports
Volume: 11
Issue: 1
Start Page: 11031
Publisher DOI: 10.1038/s41598-021-90492-0
Abstract: Trauma patients die from massive bleeding due to disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype in the early phase, which transforms to DIC with a thrombotic phenotype in the late phase of trauma, contributing to the development of multiple organ dysfunction syndrome (MODS) and a consequently poor outcome. This is a sub-analysis of a multicenter prospective descriptive cross-sectional study on DIC to evaluate the effect of a DIC diagnosis on the survival probability and predictive performance of DIC scores for massive transfusion, MODS, and hospital death in severely injured trauma patients. A DIC diagnosis on admission was associated with a lower survival probability (Log Rank P<0.001), higher frequency of massive transfusion and MODS and a higher mortality rate than no such diagnosis. The DIC scores at 0 and 3 h significantly predicted massive transfusion, MODS, and hospital death. Markers of thrombin and plasmin generation and fibrinolysis inhibition also showed a good predictive ability for these three items. In conclusion, a DIC diagnosis on admission was associated with a low survival probability. DIC scores obtained immediately after trauma predicted a poor prognosis of severely injured trauma patients.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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