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A Practical Guide to Haemostasis


Disseminated Intravascular Coagulation [DIC]

Introduction

DIC is a potentially fatal disorder and a number of algorithms have been developed to assist in its diagnosis and to predict mortality.  There are a number of causes of DIC but collectively these lead to systemic activation of coagulation and the widespread deposition of Fibrin leading to the generation of microthrombi and multiple organ dysfunction/failure. In critically ill patients with DIC the 28-day mortality is 20-50% and therefore, early diagnosis and treatment is of fundamental importance.

A number of the Algorithms are summarised below with links to the relevant pages/algorithms.

The ISTH DIC Score


The ISTH Overt DIC Scoring algorithm was developed by the SSC committee on DIC and published in 2001. This algorithm is only appropriate for use in patients with an underlying disorder that is known to be associated with DIC.

Click HERE to access the ISTH DIC Algorithm.

 

The ISTH DIC Score
Modifications for use in Pregnancy

DIC is a recognised cause of maternal mortality and a modification of the ISTH DIC Scoring algorithm was developed for use in pregnancy.  The modifications are necessary due to the changes in haemostasis that occur in normal pregnancy.

Click HERE to access the modified ISTH DIC score for use in pregnancy.


The Japanese Society on Thrombosis & Haemostasis: JSTH-DIC Algorithm

The Japanese Society on Thrombosis and Haemostasis have proposed a number of algorithms for the investigation of a patient with suspected DIC.

Click HERE to access the JSTH-DIC Algorithm.

The Japanese Society on Thrombosis & Haemostasis: The Simplified JSTH-DIC Algorithm


A simplified JSTH-DIC diagnostic algorithm was created for the investigation of patients with a septic coagulopathy and this shows a similar performance to JSTH-DIC criteria.

Click HERE to access the JSTH-DIC Algorithm.


The Japanese Ministry of Health, Labour and Welfare [JMHW]: JMHW-DIC Algorithm

The Japanese Ministry of Health, Labour and Welfare [JMHW] algorithm is summarised in the section in The Japanese Society on Thrombosis and Haemostasis.

Click HERE to access the JSTH-DIC Algorithm.

 

The Japanese Association for Acute Medicine [JAAM]: JAAM-DIC Algorithm

The JAAM DIC scoring algorithm includes a number of variables but in addition specific criteria for evidence of a Systemic Inflammatory Response Syndrome [SIRS].

Click HERE to access the JAAM-DIC Algorithm.