Diagnostic Criteria for Disseminated Intravascular Coagulation (DIC)

Disseminated intravascular coagulation is a condition in which small blood clots develop throughout the bloodstream, blocking small blood vessels. The increased clotting depletes the platelets and clotting factors needed to control bleeding, causing excessive bleeding.

Classification

Definition

Diagnostic criteria

Biological DIC

Hemostatic defect without clinical manifestations

Elevated D-Dimers

and

1 major criterion for consumption of platelets or coagulation factors

or

2 minor criteria for consumption of platelets or coagulation factors

Clinical DIC

Hemostatic defect with hemorrhagic or ischemic manifestations

Same as above + microvascular bleeding and/or thrombosis

Complicated DIC

Hemostatic defect with hemorrhagic or ischemic manifestations that jeopardize organ function or patient prognosis

Same as above + organ failure (single or multiple)

Details of laboratory criteria

D-Dimers greater than 500 µg·L–1

Platelet consumption

  • Minor: platelet count between 50 and 100,000·/mm3

  • Major: platelet count less than 50,000·/mm3

Consumption of coagulation factors

  • Minor: INR of the PT between 1.2 and 1.5

  • Major: INR of the PT greater than 1.5

INR of the PT = international normalized ratio of the prothrombin time. The elevation of D-Dimers is not specific to DIC. Similarly, the clinical manifestations of DIC are not specific.

 

 

References;

  1. Taylor FB Jr, Toh CH, Hoots WK, Wada H, Levi M; Scientific Subcommittee on Disseminated Intravascular Coagulation (DIC) of the International Society on Thrombosis and Haemostasis (ISTH). Towards definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. Thromb Haemost. 2001 Nov;86(5):1327-30. [Medline]
Created: August 04, 2005