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Prospective evaluation of hemostatic abnormalities in overt DIC due to various underlying diseases

Kazuo Kawasugi1, Hideo Wada, Tsuyoshi Hatada

  • 1Department of Internal Medicine, Teikyo University School of Medicine, Itabashi.

Thrombosis Research
|March 25, 2011
PubMed

Insights

Disseminated intravascular coagulation (DIC) diagnosis and outcomes vary by underlying disease. Hemostatic markers are useful but their sensitivity differs, guiding clinical decisions in managing DIC patients.

Area of Science:

  • Hematology
  • Clinical Medicine
  • Pathophysiology

Background:

  • Disseminated intravascular coagulation (DIC) is a complex syndrome with diverse underlying causes.
  • Understanding the impact of various etiologies on DIC diagnosis and prognosis is crucial for effective patient management.

Purpose of the Study:

  • To prospectively evaluate patients with suspected DIC.
  • To examine the utility of various hemostatic markers in diagnosing DIC across different underlying diseases.
  • To correlate DIC diagnosis with patient outcomes based on the primary condition.

Main Methods:

  • Prospective evaluation of patients with suspected DIC.
  • Assessment of hemostatic markers (e.g., platelet count, FDP, fibrinogen, prothrombin time, plasmin plasmin inhibitor complex, soluble fibrin monomer complex, antithrombin, thrombomodulin).
  • Analysis of DIC resolution rates and outcomes in relation to underlying diseases (infectious diseases, hematologic malignancies, solid tumors, obstetric diseases, trauma/burns).

Main Results:

  • Infectious diseases, hematologic malignancies, and solid tumors were the main underlying causes of DIC.
  • High DIC resolution rates were observed in obstetric diseases and hematologic malignancies.
  • DIC diagnosis correlated with poor outcomes in trauma/burn victims and infectious disease patients.
  • Specific marker utility varied: prothrombin time was sensitive overall, but fibrinogen was not for infectious DIC.
  • Plasmin plasmin inhibitor complex (hematologic malignancy) and soluble fibrin monomer complex, antithrombin, and thrombomodulin (infectious disease) showed diagnostic sensitivity.

Conclusions:

  • Hemostatic markers are valuable for DIC diagnosis, but their effectiveness is disease-specific.
  • Exclusion criteria for DIC include high platelet counts in malignancy/solid tumors or low FDP/fibrinogen levels.
  • Tailoring diagnostic marker selection based on the underlying disease improves DIC management and patient outcomes.

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