What is the ISTH scoring system for the diagnosis of overt disseminated intravascular coagulation (DIC)?

Updated: Dec 06, 2020
  • Author: Marcel M Levi, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

The diagnosis of DIC relies on multiple clinical and laboratory determinations. The International Society on Thrombosis and Haemostasis (ISTH) developed a simple scoring system for the diagnosis of overt DIC that makes use of laboratory tests available in almost all hospital laboratories (see the image below, and the DIC Score calculator.) [4] The presence of an underlying disorder known to be associated with DIC (see Etiology) is a sine qua non for the use of this diagnostic algorithm.

Diagnostic algorithm for the diagnosis of overt disseminated intravascular coagulation.

Diagnostic algorithm for the diagnosis of overt di Diagnostic algorithm for the diagnosis of overt disseminated intravascular coagulation.

A score of 5 or higher indicates overt DIC, whereas a score of less than 5 does not rule out DIC but may indicate DIC that is not overt. [4] Prospective validation studies show this scoring system to be highly accurate for the diagnosis of DIC. The sensitivity of the DIC score for a diagnosis of DIC is 91-93%, and the specificity is 97-98%. [64, 66]


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