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 hematopoietic disorder.
Patient selection: suspected DIC with hematopoietic disorder
For hematopoietic disorders the platelet count is not included.
Parameters:
(1) prothrombin time ratio
(2) fibrinogen in mg/dL
(3) fibrin degradation products in µg/mL (mg/L)
(4) antithrombin in percent of normal
(5) molecular marker (soluble fibrin, thrombin antithrombin complex, soluble fibrin monomer complex) as multiple of upper limit of normal
(6) 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
antithrombin
> 70%
0
<= 70%
1
molecular marker ratio
< 2
0
>= 2
1
liver failure
absent
0
present
-3
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: -3
• maximum score: 9
• A score >= 4 indicates DIC.
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