Wada Hideo, Yamamoto Akitaka, Tomida Masaki, Ichikawa Yuhuko, Ezaki Minoru, Masuda Jun, Yoshida Masamichi, Fukui Shunsuke, Moritani Isao, Inoue Hidekazu, Shiraki Katsuya, Suzuki Kei, Imai Hiroshi, Shimaoka Motomu, Shimpo Hideto
Department of General and Laboratory Medicine, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan.
Department of Emergency and Critical Care Center, Mie Prefectural General Medical Center, Yokkaichi 510-0885, Japan.
J Clin Med. 2022 Feb 16;11(4):1028. doi: 10.3390/jcm11041028.
The diagnostic criteria for disseminated intravascular coagulation (DIC) vary and are complicated and the cut-off values are different. Simple and quick diagnostic criteria for DIC are required in physicians for critical care.
Platelet counts, prothrombin time-international normalized ratio (PT-INR) and D-dimer levels were examined in 1293 critical ill patients. Adequate cut-off values of these parameters were determined and a quick DIC score using these biomarkers was proposed. The quick DIC score was evaluated using a receiver operating characteristic (ROC) analysis.
Using the Japanese Ministry of Health, Labor and Welfare diagnostic criteria, 70 and 109 patients were diagnosed with DIC and pre-DIC, respectively. The ROC analysis of factors difference between DIC and non-DIC, revealed the following cut-off values: PT-INR, 1.20; platelet count, 12.0 × 10/L and D-dimer, 10.0 μg/mL. Based on the above results, the quick DIC score system was proposed. All patients with DIC had a quick DIC score of 3, 4 or 5, and 85.3% of the patients with pre-DIC had a quick DIC score of ≥3 points. All patients with pre-DIC had a score of ≥2 points. In the ROC analysis, the area under the curve was 0.997 for DIC vs. non-DIC, and 0.984 for pre-DIC + DIC vs. non-DIC, and the cut-off value was 3 points for DIC and 2 points for DIC + pre-DIC. The quick DIC scores of non-survivors were significantly higher than those of survivors.
The Quick DIC score system is a simple and useful tool that can be used for the diagnosis of DIC and pre-DIC. Further evaluation of the quick DIC score system in a large-scale study is required.
弥散性血管内凝血（DIC）的诊断标准各异，复杂且临界值不同。重症监护医生需要简单快速的DIC诊断标准。
对1293例重症患者进行血小板计数、凝血酶原时间 - 国际标准化比值（PT - INR）和D - 二聚体水平检测。确定这些参数的合适临界值，并提出使用这些生物标志物的快速DIC评分。使用受试者工作特征（ROC）分析评估快速DIC评分。
根据日本厚生劳动省诊断标准，分别有70例和109例患者被诊断为DIC和前DIC。DIC与非DIC之间因素差异的ROC分析显示以下临界值：PT - INR为1.20；血小板计数为12.0×10⁹/L，D - 二聚体为10.0μg/mL。基于上述结果，提出了快速DIC评分系统。所有DIC患者的快速DIC评分为3、4或5分，85.3%的前DIC患者快速DIC评分≥3分。所有前DIC患者的评分为≥2分。在ROC分析中，DIC与非DIC比较时曲线下面积为0.997，前DIC + DIC与非DIC比较时为0.984，DIC的临界值为3分，DIC + 前DIC的临界值为2分。非幸存者的快速DIC评分显著高于幸存者。
快速DIC评分系统是一种简单有用的工具，可用于诊断DIC和前DIC。需要在大规模研究中对快速DIC评分系统进行进一步评估。
