Application of the International Normalized Ratio (INR) in the Scoring System for Disseminated Intravascular Coagulation (DIC)

2010 ◽  
Author(s):  
Hyun Kyung Kim ◽  
Ki Ho Hong ◽  
Cheng Hock Toh ◽  
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Scoring System ◽  
International Normalized Ratio ◽  
Intravascular Coagulation

scholarly journals International Normalized Ratio Relevance to the Observed Coagulation Abnormalities in Warfarin Treatment and Disseminated Intravascular Coagulation

2018 ◽  
Vol 24 (7) ◽  
pp. 1033-1041 ◽  
Author(s):  
Amanda Walborn ◽  
Mark Williams ◽  
Jawed Fareed ◽  
Debra Hoppensteadt
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
International Normalized Ratio ◽  
Clotting Factor ◽  
Plasma Samples ◽  
Intravascular Coagulation ◽  
Coagulation Abnormalities ◽  
Warfarin Treatment ◽  
Patient Groups ◽  
Coagulation Status ◽  
Anticoagulated Patients

The development of coagulation abnormalities is common in patients with sepsis. Sepsis-associated coagulopathy (SAC) is typically diagnosed by prothrombin time (PT) prolongation or elevated international normalized ratio (INR) in conjunction with reduced platelet count. INR is also used to monitor warfarin-treated patients. However, due to the different natures of SAC and warfarin anticoagulation, it is likely that the same INR value provides different information in these two patient populations. The purpose of this study was to compare measures of coagulation function and clotting factor levels in patients with SAC to those observed in patients receiving warfarin anticoagulation. Deidentified plasma samples were collected at baseline from patients diagnosed with SAC and from patients receiving warfarin. These plasma samples were evaluated for PT/INR, activated partial thromboplastin time (aPTT), fibrinogen, and functional and immunologic levels of factors VII, IX, and X. Both aPTT and fibrinogen correlated with INR in patients with SAC, but not in patients treated with warfarin. Factors VII, IX, and X showed an inverse relationship with INR in the anticoagulated patients; however, no relationship between factor level and INR was observed in patients with SAC. Distinct patterns of coagulopathy were observed in patients with SAC and patients receiving warfarin anticoagulation, and equivalent INR values were associated with distinct coagulation profiles in the two patient groups. These results suggest that an abnormal INR provides different information about the coagulation status in patients with disseminated intravascular coagulation than in patients receiving warfarin. This may indicate that an equivalently increased INR predicts different bleeding risks in these two patient groups.

Towards Definition, Clinical and Laboratory Criteria, and a Scoring System for Disseminated Intravascular Coagulation

2001 ◽  
Vol 86 (11) ◽  
pp. 1327-1330 ◽  
Author(s):  
Fletcher Taylor ◽  
Cheng-Hock Toh ◽  
Keith Hoots ◽  
Hideo Wada ◽  
Marcel Levi
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Scoring System ◽  
Intravascular Coagulation

scholarly journals Associations Among Coagulation-Related Variables, Resolution of Disseminated Intravascular Coagulation (DIC), and Mortality in Patients with Sepsis-Induced DIC Treated with Recombinant Human Soluble Thrombomodulin: A Retrospective Observational Study

2021 ◽  
Author(s):  
Chieko Mitaka ◽  
Izumi Kawagoe ◽  
Daizoh Satoh ◽  
Masakazu Hayashida
Keyword(s):  
Platelet Count ◽  
Observational Study ◽  
Disseminated Intravascular Coagulation ◽  
Early Phase ◽  
Degradation Products ◽  
International Normalized Ratio ◽  
Soluble Thrombomodulin ◽  
Intravascular Coagulation ◽  
Before And After ◽  
Recombinant Human Soluble Thrombomodulin

Abstract Background: We evaluated associations among coagulation-related variables, resolution of disseminated intravascular coagulation (DIC), and mortality in patients with sepsis-induced DIC treated with recombinant human soluble thrombomodulin (rTM). Methods: We retrospectively investigated patients with sepsis-induced DIC treated with rTM. Changes in coagulation-related variables before and after treatment with rTM were examined. Further, associations between coagulation-related variables and DIC resolution were evaluated. Results: A total of 123 patients were included. The platelet count, prothrombin international normalized ratio (PT-INR), and fibrin/fibrinogen degradation products (FDP) significantly (p < 0.001) improved after rTM administration in survivors (n = 98), but not in nonsurvivors (n = 25). However, the DIC score significantly (p < 0.001) reduced not only in survivors but also in nonsurvivors. PT-INR before rTM was significantly (p = 0.0029) lower in patients attaining than not attaining DIC resolution (n = 87 and 36, respectively). The 28-day mortality was significantly lower in patients attaining than not attaining DIC resolution (11.5% vs. 41.7 %, p = 0.0001).Conclusions: The DIC score significantly reduced after rTM in both survivors and nonsurvivors. rTM might play an important role in improving DIC, especially when treatment with rTM is initiated in the early phase of DIC.

Scoring System for Diagnosis of Disseminated Intravascular Coagulation (DIC)

1979 ◽  
Author(s):  
A.H. Sutor
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Scoring System ◽  
Haemolytic Uraemic Syndrome ◽  
Antithrombin Iii ◽  
Vascular Damage ◽  
Clinical Parameters ◽  
Consumption Coagulopathy ◽  
Intravascular Coagulation ◽  
Hyaline Membrane ◽  
Gelation Test

A scoring system for diagnosis of DIC is proposed which encludes anam estic, clinical and laboratory criteria. From anamnestic criteria triwerinp event which lead to microeirculatory disturbances, like peripheral stasis (hysovolaemia, cardia; insufficiency) thrombin-inducers (septicaemia, haemolysis) and vascular damage (haemolytic-uraemic-syndrome, g ant haemangioma) score1 point as well as a positive etnanol gelation test. Clinical parameters include all organs which show sirns of a throrr. ho-haemormafic syndrom. They represent shock-orpans and can be diagnosed clinically by simultaneous appearance of bleeding symptoms and microthromrosis, like oliguria and haematuria (shock-orean kidney) or purpura and “Intravital death sports” (shock-orfran skin) or haemoptoe and hyaline membrane (shock-organ lunps). Laboratory parameters of DIC include the annearanee of helmet cells, of leuko- or neutropenia, of thrombocytopenia and of the demonstration of consumption coagulopathy (low F I, II, V, XIII) and of fibrinolysis (increased FDP, low plasminogen, low Antithrombin III). From our experience a score of 7 points or more is compatible with DIC.

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