Criteria of the ISTH Scientific and Standardization Committee for Non-Overt DIC

Description

Non-overt disseminated intravascular coagulation (DIC) can be diagnosed if certain clinical and laboratory findings are present. The authors are from the Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH).

NOTE: This score assumes that the ISTH score for recognizing overt DIC is negative (see 04.18.04. above).

Parameters:

(1) diagnosis

(2) platelet count

(3) trend in the platelet count

(4) prolongation of the prothrombin time (PT)

(5) trend in the prolongation of the PT

(6) soluble fibrin or fibrin degradation products

(7) trend in soluble fibrin or fibrin degradation products (FDP)

(8) antithrombin III

(9) protein C

(10) thrombin antithrombin (TAT) complexes

prolongation in the PT in seconds =

= (patient's PT in seconds) - (upper limit of the normal PT reference range)

Parameter	Finding	Points
diagnosis	not associated with DIC	0
	associated with DIC	2
platelet count	>= 100,000 per µL	0
	< 100,000 per µL	1
trend in the platelet count	rising	-1
	stable	0
	falling	1
prolongation of the PT	<= 3 seconds	0
	> 3 seconds	1
trend in PT prolongation	falling	-1
	stable	0
	rising	1
soluble fibrin or FDP	normal	0
	increased	1
trend in fibrin or FDP	falling	-1
	stable	0
	rising	1
antithrombin III	normal	-1
	low	1
protein C	normal	-1
	low	1
TAT complexes	normal	-1
	elevated	1

where:

• Additional coagulation tests may be added if indicated in a clinical trial. These may be scored as (-1) if normal and (+1) if favoring DIC.

• The platelet count and prolongation of the PT showed < and > values but not <= or >=. I added these as seem fit.

total score =

= SUM(points for all measured parameters)

Interpretation:

• minimum score: (-6)

• maximum score: 11

• The higher the score the more likely non-overt DIC is present.

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Description

Specialty

ICD-10