[The application of disseminated intravascular coagulation score in sepsis].

OBJECTIVE: To study the relationship between the disseminated intravascular coagulation (DIC) score and assessment of illness and prognosis in sepsis. METHODS: A retrospective analysis of 315 patients with sepsis that admitted into the First Affiliated Hospital of Zhengzhou University hospital intensive care unit (ICU) from January 2005 to December 2008 was made. The patients were divided into survival group (194 cases) and death group (112 cases) according to the outcome within 28 days. The difference of the platelet (PLT) count, fibrinogen (Fib), prothrombin time (PT), and fibrin monomer were compared between two groups. The relationship between acute physiology and chronic health evaluation II (APACHE II) score, DIC score and prognosis were analyzed by univariate logistic regression analysis, then APACHE II score and DIC score in sepsis were evaluated. RESULTS: PLT count and Fib of the death group were lower than those of the survival group, PT, activated partial thrombin time (APTT), activated clotting time (ACT) and fibrin monomer of the death group were higher than those of the survival group. APACHE II score and DIC score of the death group were higher than those of the survival group (P<0.05 or P<0.01). There was a positive correlation among APACHE II score, DIC score and the prognosis of sepsis [DIC score: chi (2)=17.741, P<0.001, odds ratio (OR)=1.413, 95% confidence interval (CI) 1.203-1.659; APACHE II score: chi (2)=36.456, P<0.001, OR=1.109, 95%CI 1.072-1.147]. Area under the curve of APACHE II score (0.706) was higher than DIC score (0.611). CONCLUSION: APACHE II score and DIC score can be used as the prognostic factors of sepsis, but the value of DIC score was lower than APACHE II score in diagnosis and prognosis of sepsis.