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 10³/microliter = 0

  • <100 x 10³/microliter = 1

  • <50 x 10³/microliter = 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:

  • 1 g/L = 0

  • <1 g/L = 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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