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Disseminated Intravascular Coagulation: Sensitivity and Specificity

Introduction: None written.

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Tags: Hematologic Tag this Diagnosis.

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Septicemia 30% similar in gram positive and gram negative sepsis

Thromb Haemost. 1999 Aug;82(2):695-705. PMID: 10605770

Trauma 50% Thromb Haemost. 1999 Aug;82(2):695-705. PMID: 10605770
Acute Leukemia 15% Thromb Haemost. 1999 Aug;82(2):695-705. PMID: 10605770
More, Edit...

The sensitivity and specificity of findings for Disseminated Intravascular Coagulation are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding SensitivitySpecificity Comments, Study
ISTH Criteria Edit 91%97%

Score

*Platelet count (>100 × 109/L = 0, <100 × 109/L = 1, <50 × 109/L = 2)

*Elevated fibrin-related marker (e.g., fibrin degradation products or D-dimer) (no increase, 0; moderate increase, 2; strong increase, 3)[a]

*Prolonged prothrombin time (<3 secs = 0, >3 but <6 secs = 1, >6 secs = 2)

*Fibrinogen level (>1.0 g/L = 0, <1.0 g/L = 1)

[a    In most prospective validation studies, D-dimer assays were used and a value above the upper limit of normal (0.4 mcg/L) was considered moderately elevated, whereas a value >10 times the upper limit of normal (4.0 mcg/L) was considered as a strong increase.]

Calculate score

If >=5: compatible with overt DIC

If <5: no overt DIC; repeat next 12 days

Study: Crit Care Med. 2004 Dec;32(12):2416-21. PMID: 15599145

Sensitive Findings

Finding SensitivitySpecificity Comments, Study
Elevated D-dimer Edit Sensitivity = 93%

specificity not assessed, generally regarded as LOW.

Study: Semin Thromb Hemost. 1996;22(1):69-88. PMID: 8711492

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Schistocytes Edit Sensitivity = 50%

irregularly shaped RBCs on blood smear, demonstrating evidence of microangiopathy (i.e. clots in small vessels)

specificity not assessed.

Study: Semin Thromb Hemost. 1996;22(1):69-88. PMID: 8711492

Prolonged PT Edit Sensitivity = 50%

specificity not assessed

Study: Semin Thromb Hemost. 1996;22(1):69-88. PMID: 8711492

Prolonged PTT Edit Sensitivity = 50%

specificity not assessed

Study: Semin Thromb Hemost. 1996;22(1):69-88. PMID: 8711492

Decreased Fibrinogen Edit Sensitivity = 28%

specificity not assessed.

Study: Thromb Haemost. 1999 Aug;82(2):695-705. PMID: 10605770