Kinasewitz et al developed a score for evaluating disseminated intravascular coagulation (DIC) in a patient with sepsis. The score can help identify a patient who may benefit from more aggressive management. The authors are from the University of Oklahoma.
Parameters:
(1) absolute platelet count
(2) change in platelet count from previous
(3) absolute prothrombin time (PT) with reference range 9.5 to 12 seconds
(4) change in prothrombin time from previous
Score A for platelet count: 2 points if the platelet count is < 60,000 per µL.
Score B for platelet count:
|
Parameter |
Finding |
Points |
|
absolute platelet count |
>= 100,000 per µL |
0 |
|
|
< 100,000 per µL |
1 |
|
change in platelet count |
increase or no change |
0 |
|
|
decrease < 20% |
0 |
|
|
decrease >= 20% |
1 |
Score C for prothrombin time: 2 points if the prothrombin time is > 20 seconds.
Score D for prothrombin time: SUM(points) for the absolute PT and change in PT
|
Parameter |
Finding |
Points |
|
prothrombin time |
< 15 seconds |
0 |
|
|
>= 15.0 seconds |
1 |
|
change in PT |
increase or no change |
0 |
|
|
decrease < 0.3 seconds |
0 |
|
|
increase >= 0.3 seconds |
1 |
evolving DIC score =
= MAX(score A, score B) + MAX(score C, score D)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the risk for multiple organ failure and the higher the mortality rate.
|
Total Score |
Mortality Rate |
|
0 |
10% |
|
1 |
16% |
|
2 |
36% |
|
3 |
50% |
|
4 |
73% |
Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
