The ISTH criteria for disseminated intravascular coagulation (DIC) is a clinical tool designed to aid in the diagnosis of DIC, a complex systemic thrombohemorrhagic disorder. The tool is particularly useful in stratifying patients based on the severity of their coagulation abnormalities, thereby facilitating timely and appropriate therapeutic interventions.
The ISTH DIC criteria incorporates four primary components: platelet count, fibrinogen degradation product level, prothrombin time (PT) prolongation, and fibrinogen level. Each component is scored based on the severity of the abnormality. For platelet count, a score of 0 is assigned for counts >= 100 x10^9/L, 1 for counts between 51-100 x10^9/L, and 2 for counts <= 50 x10^9/L. Fibrinogen degradation product level is scored as 0 for no increase, 2 for a moderate increase, and 3 for a severe increase. Prolonged PT is scored as 0 for < 3 seconds, 1 for 3-6 seconds, and 2 for >= 6 seconds. Lastly, fibrinogen level is scored as 0 for > 1 g/L and 1 for <= 1 g/L.
The total score is calculated by summing the scores from each of the four components. A score of less than 5 suggests that the criteria for DIC are not met, while a score of 5 or more meets the criteria for DIC. This scoring system allows for a standardized and objective assessment of DIC, which can be challenging to diagnose due to its variable clinical presentation and the lack of a single definitive diagnostic test.
Reference
Hideo Wada, Esteban C Gabazza, Hidesaku Asakura et al. Comparison of diagnostic criteria for disseminated intravascular coagulation (DIC): diagnostic criteria of the International Society of Thrombosis and Hemostasis and of the Japanese Ministry of Health and Welfare for overt DIC. Am J Hematol. 2003 Sep;74(1):17-22.
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