Evaluation of the Diagnostic Criteria for the Basic Type of DIC Established by the Japanese Society of Thrombosis and Hemostasis

  • Takumi Aota
    Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan
  • Hideo Wada
    Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Mie, Japan
  • Naoki Fujimoto
    Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Mie, Japan
  • Yoshiki Yamashita
    Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan
  • Takeshi Matsumoto
    Blood Transfusion Service, Mie University Graduate School of Medicine, Mie, Japan
  • Kohshi Ohishi
    Blood Transfusion Service, Mie University Graduate School of Medicine, Mie, Japan
  • Kei Suzuki
    Emergency Critical Care Center, Mie University Graduate School of Medicine, Mie, Japan
  • Hiroshi Imai
    Emergency Critical Care Center, Mie University Graduate School of Medicine, Mie, Japan
  • Masanobu Usui
    Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan
  • Shuji Isaji
    Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Mie, Japan
  • Toshimasa Uchiyama
    Department of Laboratory Medicine, Takasaki General Medical center, Takasaki, Japan
  • Yoshinobu Seki
    Department of Hematology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
  • Naoyuki Katayama
    Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan

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<jats:p> We evaluated the diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 232 patients with suspected DIC without hematopoietic injury or infection. The diagnoses of the patients were as follows: DIC (n = 116), pre-DIC (n = 54), and non-DIC (n = 63). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic analysis. The area under the curve and odds ratio for the global coagulation test (GCT) scores in the diagnosis of “DIC” were high, whereas those for the diagnosis of “DIC and pre-DIC” were low, suggesting that the addition of a reduced platelet count (RPC), antithrombin (AT), and soluble fibrin (SF)/thrombin AT (TAT) complex was required to diagnose DIC and pre-DIC. When the GCT score with the RPC, AT, and TAT/SF values was used, the cutoff DIC score for the diagnosis of DIC or DIC and pre-DIC was 6 points. For predicting the outcome, a scoring system that used the GCT result was useful, but the addition of RPC, AT, or SF/TAT was not. The modified diagnostic criteria of JSTH, which included the GCT score and the RPC, AT, and TAT/SF values, were useful for diagnosing both DIC and pre-DIC. </jats:p>

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