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    ISTH Criteria for Disseminated Intravascular Coagulation (DIC)

    Diagnoses overt disseminated intravascular coagulation (DIC).

    IMPORTANT

    We launched a COVID-19 Resource Center, including a critical review of recommended calcs.

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

    INSTRUCTIONS

    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).

    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with suspected overt disseminated intravascular coagulopathy (DIC), e.g. in the setting of malignancy, severe infection or sepsis, obstetric complications, trauma.

    • The presence of disease known to be associated with DIC (e.g. malignancy, severe infection or sepsis, obstetric complications, trauma) is a prerequisite for the use of this scoring system.

    • Increasing scores strongly correlate with higher mortality rates.

    • The coagulation profile (platelet count, PT, D-dimer, fibrinogen) provide a glimpse of the dynamic nature of DIC. It is important to repeat the tests serially for monitoring.

    • This scoring system may not be appropriate for all patients, and individual patient circumstances may indicate an alternative method. For example, if bleeding is suspected due to liver dysfunction vs DIC, liver function tests and some coagulation factors may be more appropriate to confirm the clinical suspicion.

    • DIC is a syndrome which complicates a range of diseases. It is characterized by systemic activation of pathways leading to generation of fibrin clots that may cause organ failure with concomitant consumption of platelets and coagulation factors that may result in clinical bleeding. 

    • This calculator can aid in the determination of possible overt DIC and non-overt DIC in patients with underlying conditions that may be associated with DIC.

    Diagnostic criteria for overt DIC
    ≥100
    0
    50 to <100
    +1
    <50
    +2
    No increase
    0
    Moderate increase
    +2
    Severe increase
    +3
    <3
    0
    3 to <6
    +1
    ≥6
    +2
    ≥1
    0
    <1
    +1
    Confirmed positive
    Suspected
    Unlikely
    Confirmed negative

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Fletcher B. Taylor

    About the Creator

    Fletcher B. Taylor, MS, MD, is a Distinguished Career Scientist at the Oklahoma Medical Research Foundation in Oklahoma City. He was previously the H.A. and Mary K. Chapman Chair in Medical Research. Dr. Taylor’s primary research is focused on diagnosis and treatment of sepsis.

    To view Dr. Fletcher B. Taylor's publications, visit PubMed

    Are you Dr. Fletcher B. Taylor? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Fatima Aldarweesh, MD
    About the Creator
    Dr. Fletcher B. Taylor
    Are you Dr. Fletcher B. Taylor?
    Content Contributors
    • Fatima Aldarweesh, MD