Evaluation of diagnostic criteria for DIC and cutoff values in hemostatic markers

Three diagnostic criteria for disseminated intravascular coagulation (DIC) have been published by the Japanese Ministry of Health, Labor and Welfare OMHLW), International Society of Thrombosis and Haemostasis (ISTH) and the Japanese Association for Acute Medicine (JAAM), but the standardization of the diagnosis of DIC has not yet been established. The usefulness of these criteria and modified non-overt-DIC diagnostic criteria for the diagnosis of DIC was evaluated in this study. The patients who are diagnosed with DIC have a poor outcome, suggesting that the three diagnostic criteria for DIC by JMHLW, ISTH and JAAM are useful. There was no significant difference in the prediction of a poor outcome among the three diagnostic criteria. The modified non-overt-DIC diagnostic criteria could detect almost all patients with pre-DIC and they might therefore better predict a poor outcome than the three diagnostic criteria. The outcome of DIC was different for each underlying disease and the outcome of DIC associated with infection and trauma was poor. The results of the global coagulation tests were useful for the diagnosis of DIC, and the hemostatic molecular markers were useful for evaluating the pathological state of DIC due to underlying diseases. These findings indicate that the diagnosis of DIC is important and the diagnostic criteria for DIC still need to be revised in greater detail.