Evaluation of New Japanese Diagnostic Criteria for Disseminated Intravascular Coagulation in Critically Ill Patients

Abstract

New Japanese diagnostic criteria were prepared for disseminated intravascular coagulation (DIC) in critically ill patients and their usefulness was compared with the criteria of the International Society of Thrombosis and Haemostasis (ISTH) and those of the Japan Ministry of Health and Welfare (JMHW). In a retrospective study of patients with platelet counts of less than 150 x10(3)/mL, 52 cases (33.3%), 66 cases (42.3%), and 101 cases (64.7%) were diagnosed as DIC by the ISTH, JMHW, and new Japanese DIC criteria, respectively. The DIC state as diagnosed by the new Japanese DIC criteria included both DIC states as diagnosed by ISTH or JMHW criteria. Some DIC states diagnosed by the JMHW criteria included those diagnosed by ISHT criteria but this was not universal. The mortality of DIC as diagnosed by the ISTH or JMHW criteria was markedly high, compared to that for DIC diagnosed by the new Japanese criteria. The mortality of patients without DIC by ISTH was also high when they were diagnosed as DIC by the new Japanese criteria. The frequency of DIC by each set of diagnostic criteria was significantly higher in patients with infection than in those without infection. The mortality of DIC by each set of diagnostic criteria was significantly higher in patients with infection than in those without infection, and the mortality of overt-DIC by ISTH diagnostic criteria was also high in patients without infection.

The scoring system of the Scientific and Standardisation Committee on Disseminated Intravascular Coagulation of the International Society on Thrombosis and Haemostasis: a 5‐year overview

“…Without such patients, a further comparative study showed 93% concordance [4]. Although these were mainly in patients with infection, Gando et al found mortality to be also high in the DIC of non-infected patients diagnosed using ISTH criteria [5]. Using a different approach with blinded ÔexpertÕ assessments, Bakhtiari et al found sensitivity of 91% and specificity of 97% with the ISTH DIC score [6].…”

A Prospective Comparative Study of Three Sets of Criteria for Disseminated Intravascular Coagulation: ISTH Criteria vs Japanese Criteria

“…In the present study, we examined mortality rates on the 28th day, while Gando et al (13) did not state at what point mortality rates were recorded in their 12 study. The time at which mortality rates were recorded thus may differ between the two studies, and may have contributed to the discrepancy between the results of Gando's study (13) and those of our own. The results of the present study reconfirm the moderate sensitivity and specificity of the Japanese criteria not only for diagnosing DIC but also for predicting morbidity and mortality in DIC patients.…”

“…These results suggest that the overt DIC criteria may miss patients who should be diagnosed with DIC. Gando et al (13) reported that the mortality of patients with overt DIC was higher than that of patients without overt DIC in their retrospective study. In the present study, we examined mortality rates on the 28th day, while Gando et al (13) did not state at what point mortality rates were recorded in their 12 study.…”

“…Gando et al (13) reported that the mortality of patients with overt DIC was higher than that of patients without overt DIC in their retrospective study. In the present study, we examined mortality rates on the 28th day, while Gando et al (13) did not state at what point mortality rates were recorded in their 12 study. The time at which mortality rates were recorded thus may differ between the two studies, and may have contributed to the discrepancy between the results of Gando's study (13) and those of our own.…”

Leukocyte deformability is a novel biomarker to reflect sepsis‐induced disseminated intravascular coagulation

“…In Japan, the Japanese Association for Acute Medicine (JAAM) has published a scoring system for DIC. 2 The JAAM DIC scoring system is useful for diagnosis and treatment of DIC in the early phase of sepsis. 3 However, the treatment of sepsisinduced DIC is controversial and the Surviving Sepsis Campaign Guidelines (SSCG) 2012 does not give specific recommendations for the selection criteria and timing of drug administration for patients with this disorder.…”