Criteria
International Society of Thrombosis and Haemostasis (ISTH) diagnostic algorithm for disseminated intravascular coagulation (DIC)[4]
Risk assessment: any known underlying disorder? If yes, proceeding with the algorithm is advised.
Global coagulation tests should be ordered: platelet count, soluble fibrin monomers/fibrin degradation products, prothrombin time, and fibrinogen. A specific score, reflecting the severity of abnormality, is given to each of the tests:
Platelet count:
>100 x 10⁹/L (>100 x 10³/microlitre) = 0
<100 x 10⁹/L (<100 x 10³/microlitre) = 1
<50 x 10⁹/L (<50 x 10³/microlitre) = 2.
Elevated fibrin-related markers such as soluble fibrin monomers and fibrin degradation products:
No increase = 0
Moderate increase = 2
Strong increase = 3.
Prolonged prothrombin time:
<3 seconds = 0
>3 seconds but <6 seconds = 1
>6 seconds = 2.
Fibrinogen level:
2.94 micromol/L (1 g/L or 100 mg/dL) = 0
<2.94 micromol/L (<1 g/L or <100 mg/dL) = 1.
Calculate score: a total score ≥5 is compatible with overt DIC. It is recommended to repeat scoring daily.
Total score <5 suggests non-overt DIC, and the tests should be repeated in the next 1 to 2 days.
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