Trends in the incidence and outcomes of disseminated intravascular coagulation in critically Ill patients (2004-2010): A population-based study

Balwinder Singh, Andrew C. Hanson, Rabe Alhurani, Shihan Wang, Vitaly D Herasevich, Rodrigo Cartin-Ceba, Daryl J Kor, Naseema Gangat, Guangxi Li

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: The incidence and outcomes of disseminated intravascular coagulation (DIC) are incompletely defined. Therefore, we aimed to evaluate the trends in incidence and outcomes of critically ill patients with DIC. Methods: We conducted a population-based, retrospective cohort study evaluating consecutively admitted adult (≥ 18 years old) critically ill patients with DIC at the Mayo Clinic, Minnesota, from 2004 to 2010. DIC was diagnosed according to the International Society on Thrombosis and Hemostasis' overt DIC algorithm. Patients given a diagnosis of heparin-induced thrombocytopenia, thrombotic thrombocytopenic purpura, Child Pugh class C, or any known congenital or acquired coagulation disorders were excluded. Results: Of the 8,089 Olmsted County resident ICU admissions, a total of 154 patients met the DIC inclusion criteria. The overall incidence rate of DIC/100,000 person-years decreased from 26.2 (95% CI, 17.1-38.4) in 2004 to 18.6 (95% CI, 11.3-28.7) in 2010. The incidence rate of DIC increased with age in both men and women and was consistently higher in men, with the exception of the age group 18 to 39 years. The incidence rate/100,000 person-years of DIC in men decreased from 41.6 (95% CI, 25.4-64.2) in 2004 to 21.2 (95% CI, 10.6 37.9) in 2010 (P = .01), whereas in women, it did not change significantly (P = .79). The case fatality rate did not change significantly during the study period. Conclusions: The incidence of DIC has decreased over the past decade, significantly in men, although the mortality rate remains the same. This is in agreement with trends in other critical care syndromes and could be attributable to improvements in health care delivery.

Original languageEnglish (US)
Pages (from-to)1235-1242
Number of pages8
JournalChest
Volume143
Issue number5
DOIs
StatePublished - May 2013

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Disseminated Intravascular Coagulation
Critical Illness
Incidence
Population
Thrombotic Thrombocytopenic Purpura
Mortality
Critical Care
Hemostasis
Thrombocytopenia
Heparin
Thrombosis
Cohort Studies
Retrospective Studies
Age Groups
Delivery of Health Care

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Trends in the incidence and outcomes of disseminated intravascular coagulation in critically Ill patients (2004-2010) : A population-based study. / Singh, Balwinder; Hanson, Andrew C.; Alhurani, Rabe; Wang, Shihan; Herasevich, Vitaly D; Cartin-Ceba, Rodrigo; Kor, Daryl J; Gangat, Naseema; Li, Guangxi.

In: Chest, Vol. 143, No. 5, 05.2013, p. 1235-1242.

Research output: Contribution to journalArticle

Singh, Balwinder ; Hanson, Andrew C. ; Alhurani, Rabe ; Wang, Shihan ; Herasevich, Vitaly D ; Cartin-Ceba, Rodrigo ; Kor, Daryl J ; Gangat, Naseema ; Li, Guangxi. / Trends in the incidence and outcomes of disseminated intravascular coagulation in critically Ill patients (2004-2010) : A population-based study. In: Chest. 2013 ; Vol. 143, No. 5. pp. 1235-1242.
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abstract = "Background: The incidence and outcomes of disseminated intravascular coagulation (DIC) are incompletely defined. Therefore, we aimed to evaluate the trends in incidence and outcomes of critically ill patients with DIC. Methods: We conducted a population-based, retrospective cohort study evaluating consecutively admitted adult (≥ 18 years old) critically ill patients with DIC at the Mayo Clinic, Minnesota, from 2004 to 2010. DIC was diagnosed according to the International Society on Thrombosis and Hemostasis' overt DIC algorithm. Patients given a diagnosis of heparin-induced thrombocytopenia, thrombotic thrombocytopenic purpura, Child Pugh class C, or any known congenital or acquired coagulation disorders were excluded. Results: Of the 8,089 Olmsted County resident ICU admissions, a total of 154 patients met the DIC inclusion criteria. The overall incidence rate of DIC/100,000 person-years decreased from 26.2 (95{\%} CI, 17.1-38.4) in 2004 to 18.6 (95{\%} CI, 11.3-28.7) in 2010. The incidence rate of DIC increased with age in both men and women and was consistently higher in men, with the exception of the age group 18 to 39 years. The incidence rate/100,000 person-years of DIC in men decreased from 41.6 (95{\%} CI, 25.4-64.2) in 2004 to 21.2 (95{\%} CI, 10.6 37.9) in 2010 (P = .01), whereas in women, it did not change significantly (P = .79). The case fatality rate did not change significantly during the study period. Conclusions: The incidence of DIC has decreased over the past decade, significantly in men, although the mortality rate remains the same. This is in agreement with trends in other critical care syndromes and could be attributable to improvements in health care delivery.",
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T2 - A population-based study

AU - Singh, Balwinder

AU - Hanson, Andrew C.

AU - Alhurani, Rabe

AU - Wang, Shihan

AU - Herasevich, Vitaly D

AU - Cartin-Ceba, Rodrigo

AU - Kor, Daryl J

AU - Gangat, Naseema

AU - Li, Guangxi

PY - 2013/5

Y1 - 2013/5

N2 - Background: The incidence and outcomes of disseminated intravascular coagulation (DIC) are incompletely defined. Therefore, we aimed to evaluate the trends in incidence and outcomes of critically ill patients with DIC. Methods: We conducted a population-based, retrospective cohort study evaluating consecutively admitted adult (≥ 18 years old) critically ill patients with DIC at the Mayo Clinic, Minnesota, from 2004 to 2010. DIC was diagnosed according to the International Society on Thrombosis and Hemostasis' overt DIC algorithm. Patients given a diagnosis of heparin-induced thrombocytopenia, thrombotic thrombocytopenic purpura, Child Pugh class C, or any known congenital or acquired coagulation disorders were excluded. Results: Of the 8,089 Olmsted County resident ICU admissions, a total of 154 patients met the DIC inclusion criteria. The overall incidence rate of DIC/100,000 person-years decreased from 26.2 (95% CI, 17.1-38.4) in 2004 to 18.6 (95% CI, 11.3-28.7) in 2010. The incidence rate of DIC increased with age in both men and women and was consistently higher in men, with the exception of the age group 18 to 39 years. The incidence rate/100,000 person-years of DIC in men decreased from 41.6 (95% CI, 25.4-64.2) in 2004 to 21.2 (95% CI, 10.6 37.9) in 2010 (P = .01), whereas in women, it did not change significantly (P = .79). The case fatality rate did not change significantly during the study period. Conclusions: The incidence of DIC has decreased over the past decade, significantly in men, although the mortality rate remains the same. This is in agreement with trends in other critical care syndromes and could be attributable to improvements in health care delivery.

AB - Background: The incidence and outcomes of disseminated intravascular coagulation (DIC) are incompletely defined. Therefore, we aimed to evaluate the trends in incidence and outcomes of critically ill patients with DIC. Methods: We conducted a population-based, retrospective cohort study evaluating consecutively admitted adult (≥ 18 years old) critically ill patients with DIC at the Mayo Clinic, Minnesota, from 2004 to 2010. DIC was diagnosed according to the International Society on Thrombosis and Hemostasis' overt DIC algorithm. Patients given a diagnosis of heparin-induced thrombocytopenia, thrombotic thrombocytopenic purpura, Child Pugh class C, or any known congenital or acquired coagulation disorders were excluded. Results: Of the 8,089 Olmsted County resident ICU admissions, a total of 154 patients met the DIC inclusion criteria. The overall incidence rate of DIC/100,000 person-years decreased from 26.2 (95% CI, 17.1-38.4) in 2004 to 18.6 (95% CI, 11.3-28.7) in 2010. The incidence rate of DIC increased with age in both men and women and was consistently higher in men, with the exception of the age group 18 to 39 years. The incidence rate/100,000 person-years of DIC in men decreased from 41.6 (95% CI, 25.4-64.2) in 2004 to 21.2 (95% CI, 10.6 37.9) in 2010 (P = .01), whereas in women, it did not change significantly (P = .79). The case fatality rate did not change significantly during the study period. Conclusions: The incidence of DIC has decreased over the past decade, significantly in men, although the mortality rate remains the same. This is in agreement with trends in other critical care syndromes and could be attributable to improvements in health care delivery.

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