From the Guidelines
Laboratory Tests for Disseminated Intravascular Coagulation (DIC)
The most critical laboratory tests for diagnosing and managing DIC include D-dimers, prothrombin time (PT), platelet count, and fibrinogen levels.
- These tests are essential for identifying patients at risk of developing DIC and for monitoring the progression of the disease.
- The International Society on Thrombosis and Haemostasis (ISTH) recommends measuring D-dimers, PT, platelet count, and fibrinogen levels in all patients suspected of having DIC 1.
- Elevated D-dimer levels are a consistent predictor of thrombotic events and poor overall prognosis in patients with DIC 1.
- A decrease in platelet count and fibrinogen levels, along with an increase in PT, are indicative of worsening coagulopathy and DIC 1.
- Regular monitoring of these laboratory parameters is crucial for diagnosing and managing DIC, especially in critically ill patients 1.
- The ISTH overt DIC criteria emphasize the importance of laboratory markers, including D-dimer, PT, platelet count, and fibrinogen, in diagnosing DIC 1.
From the Research
Laboratory Tests for Disseminated Intravascular Coagulation (DIC)
The following laboratory tests are commonly ordered to diagnose DIC:
- Prothrombin time (PT) 2
- Partial thromboplastin time (PTT) 2
- Fibrinogen/fibrin degradation products (FDP) 2, 3
- Fibrinogen 2, 3
- D-dimer 2, 3, 4, 5
- Platelet count 2, 3, 4
- Thrombin time 2
- Schistocytes 2
- Antithrombin 2, 3, 5
- Soluble fibrin monomer (FM) 3
- Fibrin(ogen) split products (FSP) 3
- Procalcitonin 5
- Activated factor X clotting time 5
- Clot waveform analysis 5
Test Combinations and Efficiency
Certain combinations of tests have been shown to have higher diagnostic efficiency for DIC, including:
- FDP and D-dimer combination, with a diagnostic efficiency of 95% 2
- FDP, with a diagnostic efficiency of 87% 2
- PT/PTT and FDP combination, with a diagnostic efficiency of 86% 2
- D-dimer, with a diagnostic efficiency of 80% 2
Limitations of Laboratory Tests
It is essential to note that no single test can firmly establish or rule out the diagnosis of DIC, and the results of laboratory testing should be interpreted in conjunction with clinical signs and symptoms, and identification of the underlying disease 3, 5.