DIC score in pregnant women--a population based modification of the International Society on Thrombosis and Hemostasis score
The objectives of this study were: 1) To determine the component needed to generate a validated DIC score during pregnancy. 2) To validate such scoring system in the identification of patients with clinical diagnosis of DIC. This is a population based retrospective study, including all women who gav...
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| creator | Erez, Offer Novack, Lena Beer-Weisel, Ruthy Dukler, Doron Press, Fernanda Zlotnik, Alexander Than, Nandor Gabor Tomer, Aaron Mazor, Moshe |
| description | The objectives of this study were: 1) To determine the component needed to generate a validated DIC score during pregnancy. 2) To validate such scoring system in the identification of patients with clinical diagnosis of DIC.
This is a population based retrospective study, including all women who gave birth at the 'Soroka University Medical Center' during the study period, and have had blood coagulation tests including complete blood cell count, prothrombin time (PT)(seconds), partial thromboplastin time (aPTT), fibrinogen, and D-dimers. Nomograms for pregnancy were established, and DIC score was constructed based on ROC curve analyses.
1) maternal plasma fibrinogen concentrations increased during pregnancy; 2) maternal platelet count decreased gradually during gestation; 3) the PT and PTT values did not change with advancing gestation; 4) PT difference had an area under the curve (AUC) of 0.96 (p |
| doi_str_mv | 10.1371/journal.pone.0093240 |
| format | Article |
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This is a population based retrospective study, including all women who gave birth at the 'Soroka University Medical Center' during the study period, and have had blood coagulation tests including complete blood cell count, prothrombin time (PT)(seconds), partial thromboplastin time (aPTT), fibrinogen, and D-dimers. Nomograms for pregnancy were established, and DIC score was constructed based on ROC curve analyses.
1) maternal plasma fibrinogen concentrations increased during pregnancy; 2) maternal platelet count decreased gradually during gestation; 3) the PT and PTT values did not change with advancing gestation; 4) PT difference had an area under the curve (AUC) of 0.96 (p<0.001), and a PT difference ≥1.55 had an 87% sensitivity and 90% specificity for the diagnosis of DIC; 5) the platelet count had an AUC of 0.87 (p<0.001), an 86% sensitivity and 71% specificity for the diagnosis of DIC; 6) fibrinogen concentrations had an AUC of 0.95 (p<0.001) and a cutoff point ≤3.9 g/L had a sensitivity of 87% and a specificity of 92% for the development of DIC; and 7) The pregnancy adjusted DIC score had an AUC of 0.975 (p<0.001) and at a cutoff point of ≥26 had a sensitivity of 88%, a specificity of 96%, a LR(+) of 22 and a LR(-) of 0.125 for the diagnosis of DIC.
We could establish a sensitive and specific pregnancy adjusted DIC score. The positive likelihood ratio of this score suggests that a patient with a score of ≥26 has a high probability to have DIC.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0093240</identifier><identifier>PMID: 24728139</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Blood ; Blood cells ; Blood clot ; Blood coagulation ; Blood platelets ; Breweries ; Childbirth & labor ; Coagulation ; Cut-off ; Data bases ; Diagnosis ; Dimers ; Disseminated intravascular coagulation ; Disseminated Intravascular Coagulation - diagnosis ; Embolisms ; Enzymes ; Female ; Fibrinogen ; Fibrinogen - metabolism ; Gestation ; Gynecology ; Health aspects ; Health care facilities ; Health risk assessment ; Health sciences ; Hemorrhage ; Hemostasis ; Hemostatics ; Humans ; Identification methods ; Intensive care ; Laboratories ; Likelihood ratio ; Liver ; Maternal mortality ; Medical diagnosis ; Medical records ; Medicine ; Medicine and Health Sciences ; Morbidity ; Nomograms ; Obstetrics ; Platelets ; Population ; Population studies ; Pregnancy ; Pregnancy, Complications of ; Pregnant women ; Prothrombin ; Prothrombin Time ; Research and Analysis Methods ; Retrospective Studies ; Risk factors ; Sensitivity ; Systematic review ; Thromboembolism ; Thromboplastin ; Thrombosis ; Womens health</subject><ispartof>PloS one, 2014-04, Vol.9 (4), p.e93240-e93240</ispartof><rights>COPYRIGHT 2014 Public Library of Science</rights><rights>2014 Erez et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Erez et al 2014 Erez et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-721beb1b79eec6d54d47bdd287bf9013d4e4aefa8253d7dedb49b6e620d183b23</citedby><cites>FETCH-LOGICAL-c758t-721beb1b79eec6d54d47bdd287bf9013d4e4aefa8253d7dedb49b6e620d183b23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984105/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984105/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23849,27907,27908,53774,53776,79351,79352</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24728139$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>ten Cate, Hugo</contributor><creatorcontrib>Erez, Offer</creatorcontrib><creatorcontrib>Novack, Lena</creatorcontrib><creatorcontrib>Beer-Weisel, Ruthy</creatorcontrib><creatorcontrib>Dukler, Doron</creatorcontrib><creatorcontrib>Press, Fernanda</creatorcontrib><creatorcontrib>Zlotnik, Alexander</creatorcontrib><creatorcontrib>Than, Nandor Gabor</creatorcontrib><creatorcontrib>Tomer, Aaron</creatorcontrib><creatorcontrib>Mazor, Moshe</creatorcontrib><title>DIC score in pregnant women--a population based modification of the International Society on Thrombosis and Hemostasis score</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The objectives of this study were: 1) To determine the component needed to generate a validated DIC score during pregnancy. 2) To validate such scoring system in the identification of patients with clinical diagnosis of DIC.
This is a population based retrospective study, including all women who gave birth at the 'Soroka University Medical Center' during the study period, and have had blood coagulation tests including complete blood cell count, prothrombin time (PT)(seconds), partial thromboplastin time (aPTT), fibrinogen, and D-dimers. Nomograms for pregnancy were established, and DIC score was constructed based on ROC curve analyses.
1) maternal plasma fibrinogen concentrations increased during pregnancy; 2) maternal platelet count decreased gradually during gestation; 3) the PT and PTT values did not change with advancing gestation; 4) PT difference had an area under the curve (AUC) of 0.96 (p<0.001), and a PT difference ≥1.55 had an 87% sensitivity and 90% specificity for the diagnosis of DIC; 5) the platelet count had an AUC of 0.87 (p<0.001), an 86% sensitivity and 71% specificity for the diagnosis of DIC; 6) fibrinogen concentrations had an AUC of 0.95 (p<0.001) and a cutoff point ≤3.9 g/L had a sensitivity of 87% and a specificity of 92% for the development of DIC; and 7) The pregnancy adjusted DIC score had an AUC of 0.975 (p<0.001) and at a cutoff point of ≥26 had a sensitivity of 88%, a specificity of 96%, a LR(+) of 22 and a LR(-) of 0.125 for the diagnosis of DIC.
We could establish a sensitive and specific pregnancy adjusted DIC score. The positive likelihood ratio of this score suggests that a patient with a score of ≥26 has a high probability to have DIC.</description><subject>Blood</subject><subject>Blood cells</subject><subject>Blood clot</subject><subject>Blood coagulation</subject><subject>Blood platelets</subject><subject>Breweries</subject><subject>Childbirth & labor</subject><subject>Coagulation</subject><subject>Cut-off</subject><subject>Data bases</subject><subject>Diagnosis</subject><subject>Dimers</subject><subject>Disseminated intravascular coagulation</subject><subject>Disseminated Intravascular Coagulation - diagnosis</subject><subject>Embolisms</subject><subject>Enzymes</subject><subject>Female</subject><subject>Fibrinogen</subject><subject>Fibrinogen - metabolism</subject><subject>Gestation</subject><subject>Gynecology</subject><subject>Health aspects</subject><subject>Health care facilities</subject><subject>Health risk assessment</subject><subject>Health sciences</subject><subject>Hemorrhage</subject><subject>Hemostasis</subject><subject>Hemostatics</subject><subject>Humans</subject><subject>Identification methods</subject><subject>Intensive care</subject><subject>Laboratories</subject><subject>Likelihood ratio</subject><subject>Liver</subject><subject>Maternal mortality</subject><subject>Medical diagnosis</subject><subject>Medical records</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Morbidity</subject><subject>Nomograms</subject><subject>Obstetrics</subject><subject>Platelets</subject><subject>Population</subject><subject>Population studies</subject><subject>Pregnancy</subject><subject>Pregnancy, Complications of</subject><subject>Pregnant women</subject><subject>Prothrombin</subject><subject>Prothrombin Time</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Sensitivity</subject><subject>Systematic review</subject><subject>Thromboembolism</subject><subject>Thromboplastin</subject><subject>Thrombosis</subject><subject>Womens 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score in pregnant women--a population based modification of the International Society on Thrombosis and Hemostasis score</title><author>Erez, Offer ; Novack, Lena ; Beer-Weisel, Ruthy ; Dukler, Doron ; Press, Fernanda ; Zlotnik, Alexander ; Than, Nandor Gabor ; Tomer, Aaron ; Mazor, Moshe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-721beb1b79eec6d54d47bdd287bf9013d4e4aefa8253d7dedb49b6e620d183b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Blood</topic><topic>Blood cells</topic><topic>Blood clot</topic><topic>Blood coagulation</topic><topic>Blood platelets</topic><topic>Breweries</topic><topic>Childbirth & labor</topic><topic>Coagulation</topic><topic>Cut-off</topic><topic>Data bases</topic><topic>Diagnosis</topic><topic>Dimers</topic><topic>Disseminated intravascular coagulation</topic><topic>Disseminated Intravascular Coagulation - diagnosis</topic><topic>Embolisms</topic><topic>Enzymes</topic><topic>Female</topic><topic>Fibrinogen</topic><topic>Fibrinogen - metabolism</topic><topic>Gestation</topic><topic>Gynecology</topic><topic>Health aspects</topic><topic>Health care facilities</topic><topic>Health risk assessment</topic><topic>Health sciences</topic><topic>Hemorrhage</topic><topic>Hemostasis</topic><topic>Hemostatics</topic><topic>Humans</topic><topic>Identification methods</topic><topic>Intensive care</topic><topic>Laboratories</topic><topic>Likelihood ratio</topic><topic>Liver</topic><topic>Maternal mortality</topic><topic>Medical diagnosis</topic><topic>Medical records</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Morbidity</topic><topic>Nomograms</topic><topic>Obstetrics</topic><topic>Platelets</topic><topic>Population</topic><topic>Population studies</topic><topic>Pregnancy</topic><topic>Pregnancy, Complications of</topic><topic>Pregnant women</topic><topic>Prothrombin</topic><topic>Prothrombin Time</topic><topic>Research and Analysis Methods</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Sensitivity</topic><topic>Systematic review</topic><topic>Thromboembolism</topic><topic>Thromboplastin</topic><topic>Thrombosis</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Erez, Offer</creatorcontrib><creatorcontrib>Novack, Lena</creatorcontrib><creatorcontrib>Beer-Weisel, Ruthy</creatorcontrib><creatorcontrib>Dukler, Doron</creatorcontrib><creatorcontrib>Press, Fernanda</creatorcontrib><creatorcontrib>Zlotnik, Alexander</creatorcontrib><creatorcontrib>Than, Nandor Gabor</creatorcontrib><creatorcontrib>Tomer, Aaron</creatorcontrib><creatorcontrib>Mazor, Moshe</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE 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population based modification of the International Society on Thrombosis and Hemostasis score</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>9</volume><issue>4</issue><spage>e93240</spage><epage>e93240</epage><pages>e93240-e93240</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The objectives of this study were: 1) To determine the component needed to generate a validated DIC score during pregnancy. 2) To validate such scoring system in the identification of patients with clinical diagnosis of DIC.
This is a population based retrospective study, including all women who gave birth at the 'Soroka University Medical Center' during the study period, and have had blood coagulation tests including complete blood cell count, prothrombin time (PT)(seconds), partial thromboplastin time (aPTT), fibrinogen, and D-dimers. Nomograms for pregnancy were established, and DIC score was constructed based on ROC curve analyses.
1) maternal plasma fibrinogen concentrations increased during pregnancy; 2) maternal platelet count decreased gradually during gestation; 3) the PT and PTT values did not change with advancing gestation; 4) PT difference had an area under the curve (AUC) of 0.96 (p<0.001), and a PT difference ≥1.55 had an 87% sensitivity and 90% specificity for the diagnosis of DIC; 5) the platelet count had an AUC of 0.87 (p<0.001), an 86% sensitivity and 71% specificity for the diagnosis of DIC; 6) fibrinogen concentrations had an AUC of 0.95 (p<0.001) and a cutoff point ≤3.9 g/L had a sensitivity of 87% and a specificity of 92% for the development of DIC; and 7) The pregnancy adjusted DIC score had an AUC of 0.975 (p<0.001) and at a cutoff point of ≥26 had a sensitivity of 88%, a specificity of 96%, a LR(+) of 22 and a LR(-) of 0.125 for the diagnosis of DIC.
We could establish a sensitive and specific pregnancy adjusted DIC score. The positive likelihood ratio of this score suggests that a patient with a score of ≥26 has a high probability to have DIC.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24728139</pmid><doi>10.1371/journal.pone.0093240</doi><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_plos_journals_1515291620 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Blood Blood cells Blood clot Blood coagulation Blood platelets Breweries Childbirth & labor Coagulation Cut-off Data bases Diagnosis Dimers Disseminated intravascular coagulation Disseminated Intravascular Coagulation - diagnosis Embolisms Enzymes Female Fibrinogen Fibrinogen - metabolism Gestation Gynecology Health aspects Health care facilities Health risk assessment Health sciences Hemorrhage Hemostasis Hemostatics Humans Identification methods Intensive care Laboratories Likelihood ratio Liver Maternal mortality Medical diagnosis Medical records Medicine Medicine and Health Sciences Morbidity Nomograms Obstetrics Platelets Population Population studies Pregnancy Pregnancy, Complications of Pregnant women Prothrombin Prothrombin Time Research and Analysis Methods Retrospective Studies Risk factors Sensitivity Systematic review Thromboembolism Thromboplastin Thrombosis Womens health |
| title | DIC score in pregnant women--a population based modification of the International Society on Thrombosis and Hemostasis score |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-17T08%3A14%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=DIC%20score%20in%20pregnant%20women--a%20population%20based%20modification%20of%20the%20International%20Society%20on%20Thrombosis%20and%20Hemostasis%20score&rft.jtitle=PloS%20one&rft.au=Erez,%20Offer&rft.date=2014-04-01&rft.volume=9&rft.issue=4&rft.spage=e93240&rft.epage=e93240&rft.pages=e93240-e93240&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0093240&rft_dat=%3Cgale_plos_%3EA375582699%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1515291620&rft_id=info:pmid/24728139&rft_galeid=A375582699&rft_doaj_id=oai_doaj_org_article_c11a6141a3574c1b97035aa3bc37a776&rfr_iscdi=true |