Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.

<h4>Background</h4>Viral hemorrhagic fevers (VHF) are considered to be a serious threat to public health worldwide with up to 100 million cases annually. The general hypothesis is that disseminated intravascular coagulation (DIC) is an important part of the pathogenesis. The study object...

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Autores principales:	Erik Sundberg, Johan Hultdin, Sofie Nilsson, Clas Ahlm
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/35c8911cd1c743f59abf3be8548a7bed
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spelling	oai:doaj.org-article:35c8911cd1c743f59abf3be8548a7bed2021-11-18T06:51:28ZEvidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.1932-620310.1371/journal.pone.0021134https://doaj.org/article/35c8911cd1c743f59abf3be8548a7bed2011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21731657/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Viral hemorrhagic fevers (VHF) are considered to be a serious threat to public health worldwide with up to 100 million cases annually. The general hypothesis is that disseminated intravascular coagulation (DIC) is an important part of the pathogenesis. The study objectives were to study the variability of DIC in consecutive patients with acute hemorrhagic fever with renal syndrome (HFRS), and to evaluate if different established DIC-scores can be used as a prognostic marker for a more severe illness.<h4>Method and findings</h4>In a prospective study 2006-2008, data from 106 patients with confirmed HFRS were analyzed and scored for the presence of DIC according to six different templates based on criteria from the International Society on Thrombosis and Haemostasis (ISTH). The DIC-scoring templates with a fibrinogen/CRP-ratio were most predictive, with predictions for moderate/severe illness (p<0.01) and bleeding of moderate/major importance (p<0.05). With these templates, 18.9-28.3% of the patients were diagnosed with DIC.<h4>Conclusions</h4>DIC was found in about one fourth of the patients and correlated with a more severe disease. This supports that DIC is an important part of the pathogenesis in HFRS. ISTH-scores including fibrinogen/CRP-ratio outperform models without. The high negative predictive value could be a valuable tool for the clinician. We also believe that our findings could be relevant for other VHFs.Erik SundbergJohan HultdinSofie NilssonClas AhlmPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 6, p e21134 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Erik Sundberg Johan Hultdin Sofie Nilsson Clas Ahlm Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.
description	<h4>Background</h4>Viral hemorrhagic fevers (VHF) are considered to be a serious threat to public health worldwide with up to 100 million cases annually. The general hypothesis is that disseminated intravascular coagulation (DIC) is an important part of the pathogenesis. The study objectives were to study the variability of DIC in consecutive patients with acute hemorrhagic fever with renal syndrome (HFRS), and to evaluate if different established DIC-scores can be used as a prognostic marker for a more severe illness.<h4>Method and findings</h4>In a prospective study 2006-2008, data from 106 patients with confirmed HFRS were analyzed and scored for the presence of DIC according to six different templates based on criteria from the International Society on Thrombosis and Haemostasis (ISTH). The DIC-scoring templates with a fibrinogen/CRP-ratio were most predictive, with predictions for moderate/severe illness (p<0.01) and bleeding of moderate/major importance (p<0.05). With these templates, 18.9-28.3% of the patients were diagnosed with DIC.<h4>Conclusions</h4>DIC was found in about one fourth of the patients and correlated with a more severe disease. This supports that DIC is an important part of the pathogenesis in HFRS. ISTH-scores including fibrinogen/CRP-ratio outperform models without. The high negative predictive value could be a valuable tool for the clinician. We also believe that our findings could be relevant for other VHFs.
format	article
author	Erik Sundberg Johan Hultdin Sofie Nilsson Clas Ahlm
author_facet	Erik Sundberg Johan Hultdin Sofie Nilsson Clas Ahlm
author_sort	Erik Sundberg
title	Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.
title_short	Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.
title_full	Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.
title_fullStr	Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.
title_full_unstemmed	Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.
title_sort	evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/35c8911cd1c743f59abf3be8548a7bed
work_keys_str_mv	AT eriksundberg evidenceofdisseminatedintravascularcoagulationinahemorrhagicfeverwithrenalsyndromescoringmodelsandsevereillness AT johanhultdin evidenceofdisseminatedintravascularcoagulationinahemorrhagicfeverwithrenalsyndromescoringmodelsandsevereillness AT sofienilsson evidenceofdisseminatedintravascularcoagulationinahemorrhagicfeverwithrenalsyndromescoringmodelsandsevereillness AT clasahlm evidenceofdisseminatedintravascularcoagulationinahemorrhagicfeverwithrenalsyndromescoringmodelsandsevereillness
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Evidence of disseminated intravascular coagulation in a hemorrhagic fever with renal syndrome-scoring models and severe illness.

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