A Prospective Comparative Study of Three Sets of Criteria for Disseminated Intravascular Coagulation: ISTH Criteria vs Japanese Criteria

Abstract

Clinical and laboratory criteria and a scoring system for disseminated intravascular coagulation (DIC) were recently published by the International Society on Thrombosis and Haemostasis (ISTH). In Japan, the DIC Diagnostic Standards published in 1988 have been widely used for more than 10 years. In a general intensive care unit, we prospectively compared the diagnostic properties of the overt DIC, nonovert DIC, and Japanese DIC criteria sets, and investigated the influences of each set on patient morbidity and mortality. Seventy-four patients with platelet counts below 150 × 10⁹/L were included in this study. Blood samples were collected daily from day 0 to day 4 after inclusion in the study. The Japanese DIC included the overt DIC and both of these were included in the nonovert DIC. The Japanese DIC criteria diagnosed DIC earlier than the nonovert DIC criteria did (P = .020). The DIC patients diagnosed by the Japanese criteria and those diagnosed by the overt DIC criteria showed a higher incidence of multiple organ failure than those without DIC (P = .013 and P = .022, respectively). The Japanese and the nonovert DIC criteria tended to predict patient prognoses effectively. In conclusion, the Japanese and the nonovert DIC criteria are of value in predicting outcome. However, the nonovert DIC criteria take more time to diagnose DIC than the Japanese criteria do. A more precise clinical study is needed to determined appropriate specific criteria and cutoff points in the nonovert DIC criteria set.