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Prospective evaluation of three different diagnostic criteria for disseminated intravascular coagulation

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: https://doi.org/10.1160/TH10-05-0293
Issue: 2011: 105/1 (Jan) pp. 1–205
Pages: 40-44

Prospective evaluation of three different diagnostic criteria for disseminated intravascular coagulation

T. Takemitsu (1), H. Wada (2), T. Hatada (3), Y. Ohmori (3), K. Ishikura (3), T. Takeda (3), T. Sugiyama (4), N. Yamada (5), K. Maruyama (6), N. Katayama (1), S. Isaji (7), H. Shimpo (8), M. Kusunoki (9), T. Nobori (2)

(1) Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan; (2) Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Tsu, Japan; (3) Department of Emergency Medicine, Mie University Graduate School of Medicine, Tsu, Japan; (4) Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Japan; (5) Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan; (6) Department of Anesthesia, Mie University Graduate School of Medicine, Tsu, Japan; (7) Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Japan; (8) Department of Cardiovascular Surgery, Mie University Graduate School of Medicine, Tsu, Japan; (9) Department of Digestive Surgery, Mie University Graduate School of Medicine, Tsu, Japan

Keywords

Mortality, DIC, haemostatic markers, Japanese Ministry Health and Welfare, ISTH, resolution rate

Summary

There are three different diagnostic score systems for disseminated intravascular coagulation (DIC) established by the Japanese Ministry Health and Welfare (JMHW), the International Society on Thrombosis and Haemostasis (ISTH) and the Japanese Association for Acute Medicine (JAAM). The JMHW criteria are still used in Japan. In the present study, all three diagnostic criteria were used to prospectively evaluate 413 patients with different underlying diseases of DIC who were treated at the Mie University Hospital (JMHW, n= 166; ISTH, n=143; JAAM, n=291). The odds ratio (95% confidence interval) for death was 1.88 (1.22 – 2.90) in JMHW, 2.55 (1.65 – 3.95) in ISHT and 1.99 (1.19 – 3.32) in JAAM. The platelet count, prothrombin time, fibrin and fibrinogen degradation products and fibrinogen were significantly important for diagnosis of DIC by all three diagnostic criteria. Haemostatic molecular markers were significantly high in all patients and were useful for the diagnosis of DIC. The JAAM diagnostic criteria displayed a high sensitivity for DIC and the ISTH overt-DIC diagnostic criteria displayed a high specificity for DIC. All three diagnostic criteria for DIC were related to a poor patient outcome.

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