DIC is a clinical syndrome which is initiated by exces sive thrombin generation, fibrin
formation and fibrin deposition in organs, thus resulting in multiple organ failure.
It is a frequent, often fatal complication in intensive care patients. We evaluated
a recently developed ELISA (Behringwerke) for TAT complexes in 50 healthy volunteers
and in 43 consecutive intensive care patients referred by the attending physician
on the clinical suspicion of DIC. The ELISA is based upon thrombin-antibody coated
test tubes and measurement of bound TAT complexes with peroxidase-conjugated AT III
antibody. The method has a detection limit of 0.7 μg TAT/L, a normal range of 0.97-5.4
μg/L, The intra- and inter assay v.c. at 3.3, 11.2 and 42.4 μg/L TAT levels were 5,
7, 8% and 9 , 9 and 12% resp. Patients suspected of DIC were in a clinically septic
condition (n=33), confirmed by positive bloodcultures in 18, malignancies (n=5), multiple
trauma (n=3) or solutio placentae (n=2). Of the 43 patients 29 had increased TAT levels:
mean 21.5, range 5.4-62.5. TAT levels correlated (p <0.05) with concurrently assayed
plasma fibrinogen (r=0,543), Factor V (r=0,539), platelet count (r=0,307), AT III
(r=0,317), and with plasminogen (r=0,365) (Spearman rank correlation test).
The accuracy of the TAT-test for the diagnosis of DIC was assessed in all patients.
DIC was assumed if patients fulfilled 3 of the 5 following laboratory criteria, i.e.
AT III <0.7 U/ml, factor V <0.6 U/ml, fibrinogen <1.5 g/L, platelet count <100x109/L
or a positive fdp/FDP test. The sensitivity and specificity of the TAT-test was 86
and 46% respectively, the positive and negative predictive values were 60 and 77%.
