Modified non-overt DIC diagnostic criteria predict the early phase of overt-DIC.
Diagnostic criteria for non-overt disseminated intravascular coagulation (DIC) have been proposed by the International Society of Thrombosis and Hemostasis, but are not useful for the diagnosis of early phase of overt-DIC (pre-DIC). Therefore, in the current study the non-overt DIC diagnostic criteria were modified using the global coagulation tests, the change rate in the global coagulation tests and molecular hemostatic markers to detect the pre-DIC state and were prospectively evaluated in 613 patients with underlying DIC disease. The frequencies of patients with DIC (DIC positive), late onset DIC, and without DIC (DIC absent) were 29.5%, 7.2%, and 63.3%, respectively. The modified non-overt-DIC criteria can correctly predict 43/44 patients (97.7%) who were DIC absent at admission and became DIC positive, within a week (late onset DIC state). The mortality rate was higher in DIC positive compared with pre-DIC (37.6% vs. 22.7%, P < 0.05) or DIC negative (37.6 vs. 13.7%, P < 0.01). It was also significantly higher in pre-DIC compared with DIC negative (P < 0.05). Thus, these modified non-overt DIC diagnostic criteria might therefore be useful for the diagnosis of early-phase DIC.
Wada
Hideo
H
Department of Molecular and Laboratory Medicine, Mie University School of Medicine, Tsu, Mie, Japan. wadahide@clin.medic.mie-u.ac.jp
Hatada
Tsuyoshi
T
Okamoto
Kohji
K
Uchiyama
Toshimasa
T
Kawasugi
Kazuo
K
Mayumi
Toshihiko
T
Gando
Satoshi
S
Kushimoto
Shigeki
S
Seki
Yoshinobu
Y
Madoiwa
Seiji
S
Okamura
Takashi
T
Toh
Cheng Hock
CH
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001780:Blood Coagulation Tests; D004211:Disseminated Intravascular Coagulation / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests
D015415:Biomarkers