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Factor VIII Levels and ISTH Disseminated Intravascular Coagulation Scores Do Not Distinguish Disseminated Intravascular Coagulation from the Coagulopathy of Liver Disease.
Allen, Cecily; Heskel, Marina; Butt, Ayesha; Tormey, Christopher; Pine, Alexander B; Lee, Alfred I; Gautam, Samir.
Afiliação
  • Allen C; Division of Hematology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA, callen88@jh.edu.
  • Heskel M; Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, California, USA.
  • Butt A; Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Tormey C; Department of Laboratory Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
  • Pine AB; Section of Hematology and Oncology, Connecticut Veterans Administration Health System, West Haven, Connecticut, USA.
  • Lee AI; Section of Hematology, Yale School of Medicine, New Haven, Connecticut, USA.
  • Gautam S; Section of Hematology, Yale School of Medicine, New Haven, Connecticut, USA.
Acta Haematol ; : 1-5, 2024 Jul 16.
Article em En | MEDLINE | ID: mdl-39004080
ABSTRACT

INTRODUCTION:

Distinguishing disseminated intravascular coagulation (DIC) from the coagulopathy of liver disease represents a common clinical challenge. Here, we evaluated the utility of two diagnostic tools frequently used to differentiate between these conditions factor VIII (FVIII) levels and the International Society on Thrombosis and Hemostasis (ISTH) DIC score.

METHODS:

To this end, we conducted a retrospective chart review of patients with DIC, liver disease, or both. Multiple logistic regression was performed, and receiver operating characteristic curves were generated to calculate the area under curve (AUC) for distinguishing DIC in the setting of liver disease.

RESULTS:

Among 123 patients with DIC, liver disease, or liver disease plus DIC, FVIII levels did not differ significantly. ISTH scores were lower in patients with DIC than in liver disease with or without DIC. Addition of several laboratory parameters to the ISTH score, including mean platelet volume, FV, FVIII, international normalized ratio, and activated partial thromboplastin time, improved AUC for distinguishing DIC in liver disease from liver disease alone (AUC = 0.76; p < 0.0001).

CONCLUSION:

We conclude that FVIII levels do not distinguish DIC from liver disease, and ISTH DIC scores are not predictive of DIC in patients with liver disease. Inclusion of additional lab variables within the ISTH DIC score may aid in identifying DIC in patients with liver disease.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article