What is the prevalence of disseminated intravascular coagulation (DIC)?

Updated: Oct 28, 2019
  • Author: Muhammad A Mir, MD, FACP; Chief Editor: Perumal Thiagarajan, MD  more...
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Answer

Okajima et al examined the incidence, clinical presentation, and underlying disorders associated with DIC. In their series of 1882 subjects suspected of having DIC, 204 were diagnosed with DIC, for an overall incidence of 10.8%. [70] Malignancies led the list of underlying disorders, with 33.8% of subjects having solid tumors and 12.7% having hematologic malignancies. Subjects with aortic aneurysm (10.8%), infections (6.4%), unspecified postoperative complications (4.4%), liver disease (2.9%), obstetric disorders (2.5%), and miscellaneous diseases (26.5%) completed the diverse list.

Clinical manifestations of subjects with DIC varied, depending on underlying disease. The large majority of those with aortic aneurysm (95.5%) or postoperative complications (88.9%) had no clinical signs of DIC. Bleeding was observed in all obstetrical patients and in 32-50% of those with liver disease, hematological malignancies, and solid tumors. Organ failure was observed in up to 33.3% of subjects who had DIC with liver disease, hematological malignancies, and solid tumors. Although all of the subjects with obstetric disorders had bleeding, only 20.0% had organ failure. In contrast, although only 15.4% of subjects with infections had bleeding, 76.9% of these had organ failure. [70]

In a study from Thailand, Chuansumrit et al found a similar broad spectrum of underlying diseases in 100 pediatric patients with DIC. [71] Forty-five subjects were neonates with a mean age of 12.6 days, and 55 were infants, children, and adolescents with a mean age of 6 years and 3 months. Most subjects (91.5%) had complicated underlying conditions, which included congenital anomalies, prematurity, malignancies, hematological disorders, and various diseases. The most commonly found initiator of DIC was gram-negative septicemia. Bleeding and thromboembolic events were found in 59.4% and 19.8% of participants, respectively.

Asakura et al examined the relationship between fibrinolytic enhancement and development of MSOF in 69 subjects with DIC. [72] Those with both DIC and MSOF had higher levels of TPA antigen and PAI antigen and more depressed levels of plasma alpha2-plasmin inhibitor complex (PIC) and fibrin/fibrinogen degradation products than those without MSOF.


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