Gando et al evaluated the performance of new Japanese criteria for disseminated intravascular coagulation (DIC) in critically ill patients. The authors are from multiple university hospitals in Japan participating in the Japanese Association of Acute Medicine (JAAM).
Parameters:
(1) systemic inflammatory response syndrome (SIRS)
(2) platelet count or trend over 24 hours
(3) fibrin degradation products (FDP)
(4) PT ratio (presumably the ratio of the patient's prothrombin time to the normal control, which may be either the mean of the normal reference range or the upper limit of the normal reference range)
(5) fibrinogen concentration
|
Parameter |
Finding |
Points |
|
SIRS items |
0 to 2 |
0 |
|
|
3 or more |
1 |
|
platelet count |
> 120,000 per µL |
0 |
|
|
<= 120,000 per µL |
1 |
|
|
<= 80,000 per µL |
3 |
|
|
>= 30% reduction over 24 hours |
1 |
|
|
>= 50% reduction over 24 hours |
3 |
|
fibrin degradation products |
< 10 µg/mL |
0 |
|
|
>= 10 µg/mL |
1 |
|
|
>= 25 µg/mL |
3 |
|
PT ratio |
< 1.2 |
0 |
|
|
>= 1.2 |
1 |
|
fibrinogen |
> 350 mg/dL (3.5 g/L) |
0 |
|
|
<= 350 mg/dL |
1 |
where:
• The criteria used to define SIRS were not listed. The criteria for diagnosis of SIRS from 30.08.01 are:
(1) temperature > 38° C or < 36° C
(2) heart rate > 90 beats per minute
(3) respiratory rate > 20 breaths per minute OR PaCO2 < 32 mm Hg
(4) WBC > 12,000 per µL OR < 4,000 per µL OR > 10% immature forms
• A fibrinogen of 350 mg/dL as a cutoff seems high to me.
DIC score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• A score > 5 is considered DIC.
Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
