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Disseminated intravascular coagulation (DIC) is a hematological emergency reflective of life-threatening critical illness. The DIC score was developed as a consensus guideline by hematologists as part of the International Society of Thrombosis and Hemostasis (ISTH). It was designed to be applied to patients with a critical illness known to precipitate DIC and categorizes patients into "probable overt DIC" and "not overt DIC" based on a series of laboratory parameters.
Notably, the second parameter in this equation "Increase in Fibrin Markers" is left vague and open for interpretation. The guideline authors note wide variability in assays used for D-Dimer and other fibrin breakdown markers. As a result, they explicitly state that the wide discordance amongst assays have failed to generate an evidence-based cut off point and that clinician experience and judgement is necessary in the interpretation of this score.
DIC Score collects the following variables:
Platelet count
Increase in Fibrin Markers
Prothrombin Time Prolongation
Fibrinogen Level
Citations
Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation.
Br J Haematol. 2009 Apr; 145(1):24-33.
Contributed by: Riley Golby, MD