The Japanese Society of Thrombosis and Hemostasis (JSTH) has published criteria for the diagnosis of Disseminated Intravascular Coagulation (DIC). This recognizes 3 clinical types, one of which is the "basic" type.
Patient selection: suspected DIC not due to a hematopoietic disorder or infectious disease
The basic panel includes both fibrinogen concentration and platelet count.
Parameters:
(1) prothrombin time ratio
(2) fibrinogen in mg/dL
(3) fibrin degradation products in µg/mL (mg/L)
(4) platelet count
(5) antithrombin in percent of normal
(6) molecular marker (soluble fibrin, thrombin antithrombin complex, soluble fibrin monomer complex) as multiple of upper limit of normal
(7) liver failure
prothrombin time ratio =
= (prothrombin time in seconds) / (upper limit of normal in seconds)
molecular marker ratio =
= (molecular marker value) / (upper limit of normal)
|
Parameter
|
Finding
|
Points
|
|
prothrombin time ratio
|
< 1.25
|
0
|
|
|
1.25 to 1.66
|
1
|
|
|
>= 1.67
|
2
|
|
fibrinogen
|
> 150 mg/dL
|
0
|
|
|
101 to 150 mg/dL
|
1
|
|
|
<= 100 mg/dL
|
2
|
|
fibrin degradation products
|
< 10 µg/mL
|
0
|
|
|
10 to 19.9 µg/mL
|
1
|
|
|
20 to 39.9 µg/mL
|
2
|
|
|
>= 40 µg/mL
|
3
|
|
platelet count
|
> 120,000 per µL
|
0
|
|
|
80,001 to 120,000
|
1
|
|
|
50,001 to 80,000
|
2
|
|
|
<= 50,000 per µL
|
3
|
|
antithrombin
|
> 70%
|
0
|
|
|
<= 70%
|
1
|
|
molecular marker ratio
|
< 2
|
0
|
|
|
>= 2
|
1
|
|
liver failure
|
absent
|
0
|
|
|
present
|
-3
|
total score =
= SUM(points for all 7 parameters) + (1 point if >= 30% decrease in the platelet count within 24 hours)
Interpretation:
• minimum score: -3
• maximum score: 13
• A score >= 6 indicates DIC.
