Aetiological factors, diagnosis and treatment of disseminated intravascular coagulation - a study in a tertiary care hospital

ABSTRACT

Disseminated intravascular coagulation is a syndrome, characterized by a systemic activation of the blood coagulation system. It results in the generation and deposition of fibrin, leading to microvascular thrombi in various organs contributes to the development of multi organ failure. It is always secondary to or associated with an underlying disorder.1,2 The objectives of this study were to describe the clinicopathological pattern of DIC, to find out the associated factors for DIC, and enlist different diagnostic tests and follow the therapeutic outcome and prognosis. It is a case series study. The study was carried out at Shaikh Zayed Hospital Lahore which is 750 bedded facility affiliated with FPGMI. Sociodemographic data like name, age, sex, address was collected. The history of the present illness was noticed with regard to severity of symptoms like fever, bleeding, cough, dyspnoea and altered consciousness. Patients were investigated for complete blood counts like Hb%, Platelet count, D-dimer, FDPs levels and fibrinogen level. Association factors for DIC were also noticed. In this study the most frequent association factor was found to be sepsis. Bleeding manifestations present in 90% of the patients, cough in 63.3% of the subjects. Patients with hypotension and altered consciousness were found to have a bad prognosis. Those treated with heparin infusion were not found to have a significant improvement in their clinical outcome. DIC is an important acquired coagulation abnormality most frequently associated with sepsis requiring vigorous treatment with blood products and anticoagulants