Disseminated intravascular coagulation epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2]
Overview
DIC is seen in approximately 1 percent of admissions to tertiary care hospitals. In a series of 123,231 patients admitted to university hospitals in Japan, 1286 were diagnosed with DIC (1 percent) [19]. These data may underestimate the incidence of mild, subclinical, or transient DIC. In contrast, the incidence of DIC may be lower in lower acuity settings.
The incidence of DIC in specific medical conditions is illustrated by the following examples:
●Cancer – DIC is seen in a significant number of patients with cancer. Malignancies most likely to cause DIC include acute promyelocytic leukemia, pancreatic cancer, and other mucin-producing solid tumors such as gastric, prostate, breast, and ovarian cancer [20]. In a cohort of 1117 patients with various solid tumor malignancies, DIC was diagnosed in 76 (6.8 percent) [21]. Significant risk factors for the development of DIC included age >60 years (odds ratio [OR] 5.1), male sex (OR 4.3), breast cancer (OR 4.0), tumor necrosis (OR 3.4), and advanced stage disease (OR 2.6).
●Infection – DIC is common in patients with bacterial sepsis, with increasing likelihood related to the severity of the systemic inflammatory response. In a series of 35 patients who met criteria for systemic inflammatory response syndrome for four or more consecutive days, DIC was seen in 29 (83 percent) [22]. (See "Sepsis syndromes in adults: Epidemiology, definitions, clinical presentation, diagnosis, and prognosis".)
●Trauma – In a review of 136 patients with severe trauma, 42 had DIC (31 percent) [23]. Series of patients with head trauma have reported DIC in approximately 40 percent [24,25].
●Obstetrical complications – The incidence of DIC in patients with obstetrical complications ranges from 20 percent in patients with hemolysis, elevated liver function tests, and low platelets (HELLP syndrome) to 66 percent in patients with amniotic fluid embolism [26,27]. These and other obstetrical conditions associated with DIC are discussed in detail separately. (See "Disseminated intravascular coagulation during pregnancy".)
Epidemiology and Demographics
Incidence
- The incidence of DIC is different in different diseases as it is almost always related to a life threatening condition. It depends on the cause of DIC such as cancer, infection, trauma and Obstetrical complications
- In 2010, the incidence of DIC was estimated to be 26.2 cases per 100,000 individuals worldwide.[1]
Prevalence
- The prevalence of DIC depends on the clinical settings, higher versus low acquity settings.
- In 2013, the prevalence of DIC was estimated to be 46.8% (292/624) [2]
Case-fatality rate/Mortality rate
- In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
- The case-fatality rate/mortality rate of [disease name] is approximately [number range].
Age
- Patients of all age groups may develop DIC.
Race
- There is no racial predilection to DIC
Gender
- DIC affects men and women equally
Developing Countries
References
- ↑ Singh B, Hanson AC, Alhurani R, Wang S, Herasevich V, Cartin-Ceba R, Kor DJ, Gangat N, Li G (May 2013). "Trends in the incidence and outcomes of disseminated intravascular coagulation in critically ill patients (2004-2010): a population-based study". Chest. 143 (5): 1235–1242. doi:10.1378/chest.12-2112. PMID 23139140.
- ↑ Gando S, Saitoh D, Ogura H, Fujishima S, Mayumi T, Araki T, Ikeda H, Kotani J, Kushimoto S, Miki Y, Shiraishi S, Suzuki K, Suzuki Y, Takeyama N, Takuma K, Tsuruta R, Yamaguchi Y, Yamashita N, Aikawa N (June 2013). "A multicenter, prospective validation study of the Japanese Association for Acute Medicine disseminated intravascular coagulation scoring system in patients with severe sepsis". Crit Care. 17 (3): R111. doi:10.1186/cc12783. PMC 4056654. PMID 23787004.