Takumi Aota1, Hideo Wada2, Naoki Fujimoto3, Kazushi Sugimoto3, Yoshiki Yamashita1, Takeshi Matsumoto4, Kohshi Ohishi4, Kei Suzuki5, Hiroshi Imai5, Kazuo Kawasugi6, Seiji Madoiwa7, Hidesaku Asakura8, Naoyuki Katayama1. 1. Department of Hematology and Oncology, Mie University Graduate School of Medicine, Mie, Japan. 2. Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Mie, Japan. Electronic address: wadahide@clin.medic.mie-u.ac.jp. 3. Department of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Mie, Japan. 4. Blood Transfusion Service, Mie University Graduate School of Medicine, Mie, Japan. 5. Emergency Critical Care Center, Mie University Graduate School of Medicine, Mie, Japan. 6. Department of Hematology, Teikyo University, Tokyo, Japan. 7. Department of Clinical Laboratory Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan. 8. Department of Hematology, Kanazawa University Hospital, Kanazawa, Japan.
Abstract
OBJECTIVE: We evaluated the modified diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 274 suspected DIC patients with hematopoietic injury. MATERIALS AND METHODS: The diagnoses of the patients were as follows: DIC (n=125); pre-DIC (n=42) and non-DIC (n=107). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic (ROC) analysis. RESULTS: The area under the curve (ARC) and odd's ratio for the global coagulation test (GCT) scores in the diagnosis of "DIC" were high, while those for the diagnosis of "DIC and pre-DIC" were low, suggesting that the addition of antithrombin (AT) and soluble fibrin (SF)/thrombin antithrobin complex (TAT) was required to diagnose "DIC and pre-DIC". Although the addition of the AT and SF/TAT values to the GCT did not increase its ability to predict a poor outcome, the JSTH's modified diagnostic criteria scores were correlated with the odds ratio for death. DISCUSSION AND CONCLUSION: The JSTH's modified diagnostic criteria for DIC, which included the GCT score, and the AT, and TAT/SF values, were useful for diagnosing DIC and pre-DIC, and predicting a poor outcome.
OBJECTIVE: We evaluated the modified diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 274 suspected DIC patients with hematopoietic injury. MATERIALS AND METHODS: The diagnoses of the patients were as follows: DIC (n=125); pre-DIC (n=42) and non-DIC (n=107). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic (ROC) analysis. RESULTS: The area under the curve (ARC) and odd's ratio for the global coagulation test (GCT) scores in the diagnosis of "DIC" were high, while those for the diagnosis of "DIC and pre-DIC" were low, suggesting that the addition of antithrombin (AT) and soluble fibrin (SF)/thrombin antithrobin complex (TAT) was required to diagnose "DIC and pre-DIC". Although the addition of the AT and SF/TAT values to the GCT did not increase its ability to predict a poor outcome, the JSTH's modified diagnostic criteria scores were correlated with the odds ratio for death. DISCUSSION AND CONCLUSION: The JSTH's modified diagnostic criteria for DIC, which included the GCT score, and the AT, and TAT/SF values, were useful for diagnosing DIC and pre-DIC, and predicting a poor outcome.