METHODS: The prevalence of JAAM
DIC was 46.8% (292/624), and 21% of the
DIC patients were scored according to the reduction rate of platelets. The JAAM
DIC patients were more seriously ill and exhibited more severe systemic
inflammation, a higher prevalence of
multiple organ dysfunction syndrome (
MODS) and worse outcomes than the non-
DIC patients. Disease severity, systemic
inflammation,
MODS and the mortality rate worsened in accordance with an increased JAAM
DIC score on day 1. The Kaplan-Meier curves demonstrated lower 1-year survival in the JAAM
DIC patients than in those without
DIC (log-rank test P<0.001). The JAAM
DIC score on day 1 (odds ratio=1.282, P<0.001) and the Delta JAAM
DIC score (odds ratio=0.770, P<0.001) were independent predictors of 28-day death. Dynamic changes in the JAAM
DIC score from days 1 to 4 also affected prognoses. The JAAM
DIC scoring system included all patients who met the International Society on
Thrombosis and Haemostasis overt
DIC criteria on day 1. The International Society on
Thrombosis and Haemostasis scoring system missed a large number of nonsurvivors recognized by the JAAM scoring system.
CONCLUSIONS: The JAAM
DIC scoring system exhibits good prognostic value in predicting
MODS and poor prognosis in patients with
severe sepsis and can detect more patients requiring treatment. Conducting repeated daily JAAM scoring increases the ability to predict the patient's prognosis.