Predicting neonatal mortality with a disseminated intravascular coagulation scoring system.

ABSTRACT

BACKGROUND: Although disseminated intravascular coagulation (DIC) is a critical disease, its mortality in neonates is hard to predict. The aim of this study was to investigate underlying conditions associated with neonatal DIC to see if a scoring system could predict mortality. METHODS: We retrospectively evaluated the DIC scores of neonates diagnosed on or after the second day of life, in conjunction with underlying conditions associated with DIC. The diagnosis of DIC was made according to Japan Society of Obstetrical, Gynecological & Neonatal Hematology (JSOGNH) 2016 neonatal DIC criteria. RESULTS: Among 23 neonates with DIC, 8 had gastrointestinal perforation with necrotizing enterocolitis and 6 had congenital heart disease. Although factors such as birth weight, gestational age, D-dimer, and fibrinogen were not predictive of mortality, median PT-INR differed significantly between the two groups (survived 1.69 vs died 2.37, P = 0.004). Furthermore, median DIC scores differed significantly by survival outcome (P = 0.013). CONCLUSION: DIC scores based on JSOGNH 2016 neonatal DIC criteria are predictive of mortality in infants diagnosed with DIC on or after the second day of life.