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Diagnostic and Prognostic Evaluation of Disseminated Intravascular Coagulation Using the Disseminated Intravascular

Eri Nakano1,2, Hideo Wada3, Akitaka Yamamoto4

  • 1Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu 514-8507, Japan.

Journal of Clinical Medicine
|November 13, 2025
PubMed

Insights

A new DIC index, calculated using PT-INR, D-dimer, and platelet count, shows high consistency with existing criteria for diagnosing disseminated intravascular coagulation (DIC) and predicting patient outcomes.

Area of Science:

  • Critical Care Medicine
  • Hematology
  • Thrombosis Research

Background:

  • Existing diagnostic criteria for disseminated intravascular coagulation (DIC) by JMHLW, ISTH, and JAAM are complex with varying cutoff values.
  • A need exists for a simpler, rapid diagnostic approach for DIC in critically ill patients.

Purpose of the Study:

  • To assess the utility of a novel DIC index (PT-INR x D-dimer/platelet count) for diagnosing DIC.
  • To evaluate the DIC index's ability to predict outcomes in critically ill patients.

Main Methods:

  • A retrospective analysis of 1500 critically ill patients.
  • Calculation and evaluation of the DIC index, PT-INR, D-dimer, platelet count, and established DIC scores (JMHLW, ISTH, JAAM).
  • Receiver operating characteristic (ROC) analyses were used to assess diagnostic agreement and outcome prediction.

Main Results:

  • Patients with DIC exhibited significantly higher PT-INR, D-dimer, and DIC index, with lower platelet counts compared to non-DIC patients.
  • The JMHLW score demonstrated the highest diagnostic agreement among the evaluated criteria.
  • Higher PT-INR, D-dimer, DIC index, and established DIC scores were associated with non-survival, while lower platelet counts were observed in survivors.

Conclusions:

  • The developed DIC index demonstrates strong consistency with established diagnostic criteria for DIC.
  • The DIC index is a valuable tool for both diagnosing DIC and predicting patient outcomes in critical care settings.

Keywords:
D-dimerDICDIC indexPT-INRplatelet count

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