An Evaluation of the Modified Diagnostic Criteria for DIC Established by the Japanese Society of Thrombosis and Hemostasis.
OBJECTIVE
We evaluated the modified diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH) in 108 patients with suspected infectious DIC.


METHODS
The diagnoses of the patients were as follows: DIC (n = 63), pre-DIC (n = 22), and non-DIC (n = 45). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver-operating characteristic analysis.


RESULTS
Although the area under the curve for global coagulation test (GCT) scores in the diagnosis of "DIC" was high that for the diagnosis of "DIC and pre-DIC" was low, suggesting that the addition of antithrombin (AT), soluble fibrin (SF)/thrombin-AT complex (TAT), and reduced platelet count (PLT) values was required to diagnose "DIC and pre-DIC." Using GCT score with the AT, SF/TAT, and reduced PLT values, the cutoff value of the DIC score for the diagnosis of "DIC and pre-DIC" was 5 points.


CONCLUSIONS
The modified JSTH's diagnostic criteria for DIC, which used the GCT score and the reduced PLT, AT, and TAT/SF values, were useful for diagnosing "DIC and pre-DIC."
1 Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan.
Takumi
T
Aota
2 Departments of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Mie, Japan.
Hideo
H
Wada
1 Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan.
Yoshiki
Y
Yamashita
3 Blood Transfusion Service, Mie University Graduate School of Medicine, Mie, Japan.
Takeshi
T
Matsumoto
3 Blood Transfusion Service, Mie University Graduate School of Medicine, Mie, Japan.
Kohshi
K
Ohishi
4 Emergency Critical Care Center, Mie University Graduate School of Medicine, Mie, Japan.
Kei
K
Suzuki
4 Emergency Critical Care Center, Mie University Graduate School of Medicine, Mie, Japan.
Hiroshi
H
Imai
5 Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan.
Masanobu
M
Usui
5 Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan.
Shuji
S
Isaji
6 Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan.
Hidesaku
H
Asakura
7 Department of Surgery, Yahata Municipal Hospital, Fukuoka, Japan.
Kohji
K
Okamoto
1 Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan.
Naoyuki
N
Katayama
D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III; D000991:Antithrombins / Q000097:blood; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis*; D005260:Female; D005337:Fibrin / Q000032:analysis; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D010976:Platelet Count; D017410:Practice Guidelines as Topic / Q000592:standards*; D012372:ROC Curve; D012720:Severity of Illness Index
D000991:Antithrombins; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D005337:Fibrin; D010447:Peptide Hydrolases
DIC; diagnostic criteria; infection; pre-DIC