Korean J Hematol.  2010 Dec;45(4):260-263. 10.5045/kjh.2010.45.4.260.

Diagnosis of non-overt disseminated intravascular coagulation made according to the International Society on Thrombosis and Hemostasis criteria with some modifications

• Lee JH
• Song J

• KMID: 2252037
• DOI: http://doi.org/10.5045/kjh.2010.45.4.260

Abstract

BACKGROUND
An early diagnosis of disseminated intravascular coagulation (DIC) before its progression to an overt stage is necessary for early treatment and positive outcomes. In 2001, the Scientific and Standardization Committee (SCC) of the International Society on Thrombosis and Hemostasis (ISTH) proposed new criteria for the preclinical diagnosis of overt and non-overt DICs. We investigated the clinical usefulness of the modified ISTH criteria for non-overt DIC diagnosis.
METHODS
We enrolled 296 DIC patients (170 males and 126 females) admitted and evaluated at the Gangnam Severance Hospital, Seoul, Korea, between March 2006 and April 2007. Hemostatic tests, including platelet counts, prothrombin time (PT), D-dimer levels with antithrombin, and protein-C levels, were evaluated by excluding negative scores with clinical signs, in which more than 5 points of interest denoted non-overt DIC. Mortality rates were also evaluated.
RESULTS
There were 289 patients with increased D-dimer levels and significant parametric changes suggesting DIC progression. Protein C and antithrombin levels were lower (99.2% each) and appeared earlier in patients with non-overt DIC than in patients with overt DIC. In all, 125 (43.3%) patients had non-overt DIC and, of which 27 died (mortality rate, 21.6%). The sensitivity and specificity for mortality were 73.0% and 55.9%, respectively, which were same as those for the original ISTH criteria.
CONCLUSION
The modified ISTH criteria can be used for the early detection of non-overt DIC, and may be useful for the improvement of outcomes of non-overt DIC patients.

Keyword

Diagnosis; Non-overt disseminated intravascular coagulation; International Society on Thrombosis and Hemostasis (ISTH)

MeSH Terms

Dacarbazine
Disseminated Intravascular Coagulation
Early Diagnosis
Fibrin Fibrinogen Degradation Products
Hemostasis
Humans
Korea
Male
Platelet Count
Protein C
Prothrombin Time
Sensitivity and Specificity
Thrombosis
Dacarbazine
Fibrin Fibrinogen Degradation Products
Protein C

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