title: Modified non-overt DIC diagnostic criteria predict the early phase of overt-DIC.
abstract: 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.
authors.affiliation: Department of Molecular and Laboratory Medicine, Mie University School of Medicine, Tsu, Mie, Japan. wadahide@clin.medic.mie-u.ac.jp
authors.forename: Hideo
authors.initials: H
authors.lastname: Wada
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hatada
authors.forename: Kohji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Uchiyama
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kawasugi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Gando
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kushimoto
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Seki
authors.forename: Seiji
authors.initials: S
authors.lastname: Madoiwa
authors.forename: Takashi
authors.initials: T
authors.lastname: Okamura
authors.forename: Cheng Hock
authors.initials: CH
authors.lastname: Toh
mesh_terms: 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
chemical_list: D015415:Biomarkers