Evaluation of Global Test for the Diagnosis of DIC by the Criteria established by the Japanese Ministry of Health and Welfare

DOI 10 Citations 29 References
  • WADA Hideo
    Department of Clinical laboratory, Mie University School of Medicine
  • NOBORI Tsutomu
    Department of Clinical laboratory, Mie University School of Medicine
  • MORI Yoshitaka
    Second Department of Internal Medicine, Mie University School of Medicine
  • KANEKO Toshihiro
    Second Department of Internal Medicine, Mie University School of Medicine
  • SHIKU Hiroshi
    Second Department of Internal Medicine, Mie University School of Medicine
  • Gabazza Esteban C
    Third Department of Internal Medicine, Mie University School of Medicine
  • GANDO Satoshi
    Division of Acute and Critical Care Medicine, Hokkaido University Graduate School of Medicine
  • IBA Toshiaki
    Department of Surgery, Urayasu Hospital in Juntendou University School of Medicine
  • ASAKURA Eisaku
    Third Department of Internal Medicine, Kanazawa University School of Medicine
  • UCHIYAMA Toshimasa
    Third Department of Internal Medicine, Takasaki National Hospital
  • KAWASUGI Kazuo
    Department of Internal Medicine, Teikyo University School of Medicine
  • KOIKE Kaoru
    Department of Emergency and Critical Care Medicine, Nippon Medical School
  • OKAMOTO Kohji
    First Department of Surgery, University of Occupational and Environmental Health School of Medicine
  • HAYASHI Tomohiro
    Third Department of Internal Medicine, Yamagata University School of Medicine
  • MARUYAMA Ikurou
    Department of Clinical laboratory, Kagoshima University School of Medicine

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Other Title
  • 厚生省ＤＩＣ診断基準を用いたＤＩＣ診断におけるＧｌｏｂａｌ　Ｔｅｓｔの評価

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The criterion for the diagnosis of the disseminated intravascular coagulation syndrome (DIC) established by the Ministry of Health and Welfare of Japan was subjected for evaluation in patients with DIC associated with hematopoietic tumors (375) and non-hematopoietic tumors (551). Bleeding was frequent in the DIC group (>60%) and organ failures were frequently observed in the group of patients with non-hematopoietic tumors. Regardless of hematopoitic or non-hematopoitic tumors, differences of the prothrombin time (PT) ratio and those of plasma fibrinogen were found to be highly significant between the DIC and non-DIC patient groups (p<0,001). The difference of the fibrinogen/fibrin degradation products (FDP) between the two groups was only slightly significant, however (p<0,05), FDP appeared to be the highest but the plasma fibrinogen was the lowest in terms of the sensitivity for the diagnosis of DIC, whereas the plasma fibrinogen was the highest and FDP was the lowest in terms of its specificity. The receiver operating characteristic analysis showed that FDP, the PT ratio, platelet counts and plasma fibrinogen were useful for the diagnosis of DIC in this order. To elevate the cut-off value of FDP and to reduce that of the PT ratio thus seem to be more efficient for the diagnosis of DIC.

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