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Disseminated Intravascular Coagulation: Sensitivity and Specificity

Introduction: None written.

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Prevalence

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

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Sensitive and Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] ISTH Criteria	+ 0 -	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 1–2 days Study: Crit Care Med. 2004 Dec;32(12):2416-21. PMID: 15599145

Sensitive Findings
Finding	Result	Sensitivity	Specificity
[ + ] Elevated D-dimer		Sensitivity = 93%
specificity not assessed, generally regarded as LOW. Study: Semin Thromb Hemost. 1996;22(1):69-88. PMID: 8711492

Poorly Diagnostic Findings
Finding	Result	Sensitivity	Specificity
[ + ] Schistocytes		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		Sensitivity = 50%
specificity not assessed Study: Semin Thromb Hemost. 1996;22(1):69-88. PMID: 8711492
[ + ] Prolonged PTT		Sensitivity = 50%
specificity not assessed Study: Semin Thromb Hemost. 1996;22(1):69-88. PMID: 8711492
[ + ] Decreased Fibrinogen		Sensitivity = 28%
specificity not assessed. Study: Thromb Haemost. 1999 Aug;82(2):695-705. PMID: 10605770