[Diagnosis of DIC based on evidence].

ABSTRACT

The diagnosis of disseminate intravascular coagulation (DIC) was first based on the detection of microthrombi, but it currently involves analysis of hemostatic abnormalities by various laboratory tests and further studies are needed to simplify diagnosis of DIC. There are three diagnostic criteria for DIC developed by the International Society of Thrombosis Haemostasis (ISTH), the Japanese Association for Acute Medicine (JAAM) and the Japanese Ministry Health and Welfare. These diagnostic criteria consist of the scoring system by the same global coagulation tests. From ROC analysis, the ability for diagnosis of DIC is similar among three diagnostic criteria. ISTH diagnostic criteria has high specificity and low sensitivity, but JAAM criteria has low specificity and high sensitivity. Several molecular hemostatic markers such as thrombin antithrombin complex, D-dimer, soluble fibrine (SF) and plasmin-plasmin inhibitor complex have to be adopted for further improvement of diagnostic criteria for DIC. Finally, prospective study for new diagnostic criteria for DIC should be carried out in infectious diseases by molecular hemostatic markers.