What are the Japanese Society on Thrombosis and Hemostasis (JSTH) diagnostic criteria for disseminated intravascular coagulation (DIC)?

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

The Japanese Society on Thrombosis and Hemostasis (JSTH) has developed diagnostic criteria for DIC based on the underlying pathology (basic, hematopoietic, or infectious). [68] The JSTH criteria are shown in Table 5, below. 

Table 5. Japanese Society on Thrombosis and Hemostasis (JSTH) Diagnostic Criteria for DIC (Open Table in a new window)

            Test Results

 

Points

Platelet count (×103/μl)*

80-120

1

51-80

2

≤50

3

Fibrin degradation products (FDP; μg/ml)**

10-19

1

20-39

2

≥40

3

Fibrinogen (mg/dl)

101-150

1

≤100

2

Prothrombin time ratio

1.25-1.66

1

≥1.67

2

Antithrombin (%)

≤70

1

TAT, SF, or F1+2

≥2-fold upper limit of normal

1

Liver failure

Acute: Prothrombin time activity 40% or International Normalized Ratio ≥1.5)

Chronic: Cirrhosis with Child-Pugh B or C (≥7 points)

-3

F1+2= prothrombin fragment 1 + 2; SF=soluble fibrin; TAT=thrombin-antithrombin complex

*For a platelet count of >50 × 103/μL, add 1 point if the count decreases ≥30% within 24 h. The maximum score for the platelet count is 3 points.

**For institutions that do not measure FDP, a D-dimer increase of ≥2-fold the upper limit of normal scores 1 point.

With the JSTH system, diagnostic scoring for DIC is as follows:

  • Basic: ≥6 points
  • Hematopoietic (note that the platelet count is not included in the score calculation): ≥4 points
  • Infectious: (note that the fibrinogen level is not included in the score calculation)  ≥5 points

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!