From the Guidelines
DIC (Disseminated Intravascular Coagulation) is diagnosed using the International Society on Thrombosis and Haemostasis (ISTH) scoring system, which evaluates parameters such as platelet count, fibrin degradation products (D-dimer), prothrombin time prolongation, and fibrinogen level, with a score of 5 or higher indicating overt DIC. The ISTH overt DIC criteria are widely used and recommended for diagnosing DIC, as they provide a standardized approach to evaluating the condition 1. The criteria include a combination of clinical and laboratory parameters, such as:
- Platelet count: <50 x 10^9/L (score 2) or 50-100 x 10^9/L (score 1)
- FDP/D-dimer: strong increase (score 3) or moderate increase (score 2)
- Prothrombin time (PT ratio): ≥6 s (score 2) or ≥3 s and <6 s (score 1)
- Fibrinogen: <100 mg/dL (score 1) A total score of 5 or higher indicates overt DIC, according to the ISTH criteria 1. It is essential to identify and treat the underlying cause of DIC, which commonly includes sepsis, trauma, malignancy, or obstetric complications. The ISTH scoring system is a valuable tool for diagnosing DIC and guiding treatment decisions, as it helps to determine which patients may benefit from specific therapies and evaluate treatment effects 1.
From the Research
DIC Criteria
The diagnostic criteria for Disseminated Intravascular Coagulation (DIC) have been established by various organizations, including the Japanese Ministry of Health, Labor and Welfare, the International Society on Thrombosis and Hemostasis (ISTH), and the Japanese Association for Acute Medicine 2, 3, 4. These criteria involve global coagulation tests, such as:
- Platelet count
- Prothrombin time
- Fibrinogen and fibrin degradation products
- Fibrinogen
Laboratory Tests
The laboratory tests used to diagnose DIC include:
- Prothrombin time
- Platelet count
- Fibrinogen
- Fibrinogen/fibrin degradation products
- Hemostatic molecular markers 5, 3, 4
Diagnostic Score Systems
There are three different diagnostic score systems for DIC:
- Japanese Ministry of Health, Labor and Welfare (JMHW) criteria
- International Society on Thrombosis and Hemostasis (ISTH) criteria
- Japanese Association for Acute Medicine (JAAM) criteria 2, 3, 4
Diagnosis and Treatment
The diagnosis and treatment of DIC should be carried out in accordance with the type of DIC, with treatment of underlying conditions recommended in most cases 2, 5, 6. The use of heparin, blood transfusions, and other therapies may be indicated in certain cases of DIC, depending on the severity and type of the condition 2, 5, 6.