A comparison of disseminated intravascular coagulation scoring systems and their performance to predict mortality in sepsis patients: A systematic review and meta-analysis.
Total: 74.0Innovation: 6Impact: 8Rigor: 8Citation: 8
Summary
Across 21 studies (n=9319), SIC and JAAM-DIC showed higher sensitivity for identifying coagulopathy and predicting outcomes, while ISTH-DIC provided higher specificity. The proposed approach is to use SIC/JAAM-DIC for early identification and ISTH-DIC for later confirmation and outcome prediction.
Key Findings
- Pooled DIC positivity: ISTH-DIC 28%, JAAM-DIC 55%, SIC 57% among 9319 sepsis patients.
- Mortality rates in positive cases: ISTH-DIC 44%, JAAM-DIC 37%, SIC 35%.
- Sensitivity/specificity for mortality prediction: ISTH-DIC 0.43/0.81; JAAM-DIC 0.73/0.46; SIC 0.71/0.49.
Clinical Implications
Adopt SIC or JAAM-DIC for early screening of sepsis-induced coagulopathy, reserving ISTH-DIC for confirmation and high-specificity prognostication.
Why It Matters
Provides quantitative guidance on which DIC score to use and when in sepsis, enabling more timely recognition and targeted anticoagulant strategies.
Limitations
- Heterogeneity across studies in sepsis definitions and timing of DIC assessment
- Limited individual patient data may constrain adjustment for confounders
Future Directions
Prospective head-to-head validation of DIC scores with standardized sepsis phenotyping and evaluation of biomarker-anchored anticoagulant strategies.
Study Information
- Study Type
- Meta-analysis
- Research Domain
- Diagnosis
- Evidence Level
- I - Systematic review and random-effects meta-analysis of 21 studies (n=9319)
- Study Design
- OTHER