Significance of Disseminated Intravascular Coagulation Score in Mortality for Children With Shock

Evaluates whether the DIC score, as defined according to the International Society of Thrombosis and Hemostasis guidelines is associated with mortality in Children with shock and DIC

Data of the patients will be collected in the form of: * Personal history (age, sex), demographics including residence. * Clinical history and examination including diagnoses, vital signs and signs of shock, cause of shock if detected. * Therapeutic history including the use of continuous vasoactive medications, volume of blood products transfused and the presence of mechanical ventilation Laboratory investigation: The four laboratory components of the DIC score were determined from 1. Complete blood count (CBC). 2. Prothrombin time (PT) 3. Platelet count 4. FDP titer Scoring systems The score was determined within the first 12 h of admission, at this time the patient was on the highest cumulative dose of these medications and used as a marker for hemodynamic instability. DIC scores were computed when all four-laboratory component

Scoring system

Component of the score 0 1 2 3 Max points possible Platelet count (/mm3 ) \>100,000 100,000\_51 ≤50,000 2 Fibrinogen (mg/dl) ≥100 \<100 1 FDP titer (mg/ml) ≤5 6\_40 \>40 3 prolonged PT (s)\<3 3\_6 \>6 2 Total score 8 All individual components are summed for a total of eight possible points. If d-dimer is used instead of FDP titer, then cutoff values for the DIC score are (0: ≤2 mg/l), (2: 2.1-8 mg/l) and (3: \>8 mg/l) Interpretation of total score: ≥5 points positive for DIC \<5 points: negative, but patients could still have "on\_ overt DIC" which could evolve into Frank DIC .If there is ongoing concern for DIC, Coagulation labs may be repeated in 12\_24 hours.

Sample size

Eighty (80) children with shock will be included in this study during the period from 1-1-2025 to 31-12-2025. Sample size was calculated by Open Epi Info version (3) according to previous study conducted by Robinder., et al (2008), by comparing two related means using confidence level 85%.