MDCalc

ISTH Criteria for Disseminated Intravascular Coagulation (DIC)

Diagnoses overt disseminated intravascular coagulation (DIC).

Tips for COVID-19: This is one measure of COVID-19 associated coagulopathy, which was associated with poor prognosis (Tang 2020).

Use only in patients with clinical suspicion for DIC (e.g. excessive bleeding in the setting of malignancy, severe infection or sepsis, obstetric complications, trauma).

Diagnostic criteria for overt DIC

Platelet count, cells x 109/L

Elevated levels of a fibrin-related marker (e.g. D-dimer, fibrin degradation products)

Use lab-specific cutoff values.

Prolonged PT, seconds

Defined as seconds above the upper limit of normal.

Fibrinogen level, g/L

Result:

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Advice

Diagnosis of DIC should be made based on an appropriate clinical suspicion supported by relevant laboratory tests.

Management

  • DIC results as a complication to a wide spectrum of disorders. It is crucial to identify the underlying clinical disorder for appropriate management.

  • DIC Score <5 - not suggestive of overt DIC, may be non-overt DIC; repeat within next 1-2 days and manage clinically as appropriate.

  • DIC Score ≥5 - compatible with overt DIC; treat for DIC as appropriate and repeat scoring daily.

Critical Actions

Comprehensive decision making should not be based only on this scoring system.

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