Disseminated Intravascular Coagulation: Likelihood Ratios

specificity not assessed.

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

specificity not assessed

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

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

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