Thromb Haemost 1995; 74(03): 848-852
DOI: 10.1055/s-0038-1649835
Original Article
Clinical Studies
Schattauer GmbH Stuttgart

Outcome of Disseminated Intravascular Coagulation in Relation to the Score when Treatment was Begun

Hideo Wada
1   The 2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan
,
Yoshihiro Wakita
1   The 2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan
,
Tutomu Nakase
1   The 2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan
,
Minori Shimura
1   The 2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan
,
Katsuyo Hiyoyama
1   The 2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan
,
Shousaburou Nagaya
1   The 2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan
,
Yoshitaka Mori
2   The Mie Red Cross Blood Center, Tsu-city, Japan
,
Hiroshi Shiku
1   The 2nd Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Japan
,
the Mie DIC study group› Author Affiliations
Further Information

Publication History

Received 10 October 1994

Accepted after resubmission 13 May 1995

Publication Date:
09 July 2018 (online)

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Summary

We examined 395 patients with disseminated intravascular coagulation (DIC) divided into two groups: non-leukemic and leukemic. In 58% of the patients as a whole, treatment of DIC resulted in complete or partial remission, while exacerbation and death occurred in 31%. The efficacy of DIC treatment in the non-leukemic group was less than that in the leukemic group, indicating that the outcome of DIC depended, in part, on the underlying disease. We examined hemostatic indicators in relation to DIC score: prothrombin time (PT) ratio, FDP, platelet count, and fibrinogen levels were found to be important indicators for the diagnosis of DIC, but not for Pre-DIC. Plasma levels of fibrin-D-dimer, thrombin-antithrombin complex (TAT), and plasmin- plasmin inhibitor complex (PPIC) were significantly increased in pre-DIC. The efficacy of treatment in relation to the DIC score when the treatment was begun showed that greater efficacy was achieved in pre-DIC than in DIC patients. The outcome was poorer with increasing DIC score, suggesting that early diagnosis and early treatment are important. On examining the relationship between outcome and hemostatic indicators, we found that the PT ratio and the levels of antithrombin, plasminogen, PPIC, the PPIC/TAT ratio, and thrombomodulin were related to outcome, suggesting that very high consumption of blood coagulation factors, liver dysfunction, hypofibrinolysis, or organ failure caused a poor outcome. Although the outcome in DIC patients may not depend substantially on plasma levels of TAT and fibrin-D- dimer, we can use these indicators to treat DIC patients at an early stage.