Proposal of Quick Diagnostic Criteria for Disseminated Intravascular Coagulation

Abstract

Background. The diagnostic criteria for disseminated intravascular coagulation (DIC) vary and are complicated and the cut-off values are different. Simple and quick diagnostic criteria for DIC are required in physicians for critical care. Material and methods. Platelet counts, prothrombin time–international normalized ratio (PT-INR) and D-dimer levels were examined in 1293 critical ill patients. Adequate cut-off values of these parameters were determined and a quick DIC score using these biomarkers was proposed. The quick DIC score was evaluated using a receiver operating characteristic (ROC) analysis. Results. Using the Japanese Ministry of Health, Labor and Welfare diagnostic criteria, 70 and 109 patients were diagnosed with DIC and pre-DIC, respectively. The ROC analysis of factors difference between DIC and non-DIC, revealed the following cut-off values: PT-INR, 1.20; platelet count, 12.0 × 1010/L and D-dimer, 10.0 μg/mL. Based on the above results, the quick DIC score system was proposed. All patients with DIC had a quick DIC score of 3, 4 or 5, and 85.3% of the patients with pre-DIC had a quick DIC score of ≥3 points. All patients with pre-DIC had a score of ≥2 points. In the ROC analysis, the area under the curve was 0.997 for DIC vs. non-DIC, and 0.984 for pre-DIC + DIC vs. non-DIC, and the cut-off value was 3 points for DIC and 2 points for DIC + pre-DIC. The quick DIC scores of non-survivors were significantly higher than those of survivors. Conclusions. The Quick DIC score system is a simple and useful tool that can be used for the diagnosis of DIC and pre-DIC. Further evaluation of the quick DIC score system in a large-scale study is required.

Assessment of the Annexin A2 as a Predictive Biomarker for the Severity of Disseminated Intravascular Coagulation in Acute Leukemia Patients

“…Low levels of PLG and the fibrinolytic inhibitors, α2plasmin inhibitor and plasminogen activator inhibitor (PAI), together with the detection of elevated amounts of D-dimers and fibrin degradation products (FDP), Barbui,2001 andHugo andAvi, 2021). Therefore these biomarkers concede predictive parameters for the severity of DIC shown in Table ( 1) in agreement with the study (Wada et al, 2022). While gender and age with a range of 19-40 years are shown in Tables (2 & 3) respectively, no significant difference in predictive severity of DIC in acute leukemia because DIC incidence decrease in middle age patients and increases in younger and older patients due to limited reserves of coagulation factors including procoagulative and anti-coagulative factors (Salonvaara et al, 2003) this founding agree with (Geyer-Roberts et al, 2022).…”

Super Formula for Diagnosing Disseminated Intravascular Coagulation Using Soluble C-Type Lectin-like Receptor 2

“…Simpler diagnostic criteria are required to facilitate the early treatment of DIC in the emergency room (ER) or intensive care unit (ICU). Therefore, the sepsis-induced coagulopathy (SIC) score [ 23 ], which includes the platelet count and sequential organ failure assessment score [ 24 ] or quick DIC score, which includes the D-dimer levels, platelet count, PT ratio, and underlying disease [ 25 ], which were recently developed, may be simpler and easier scoring systems and may be useful for diagnosing DIC or coagulopathy in patients with sepsis [ 26 ]. However, these scoring systems need to use adequate cutoff values and cannot be compared to other diagnostic criteria.…”

Plasma Soluble Fibrin Is Useful for the Diagnosis of Thrombotic Diseases

“…Elevated D-dimer levels are related to the DIC score and associated with poor outcomes [ 6 , 28 ]. However, the overt-DIC diagnostic criteria established by the International Society of Thrombosis and Haemostasis (ISTH) do not include an adequate cutoff value of D-dimer [ 29 ], and the scoring system of sepsis-induced coagulopathy dose not include D-dimer [ 30 , 31 ]. There are many D-dimer kits, which have many different cutoff values [ 16 ]; thus, the standardization of D-dimer has not been established.…”