Evaluation of haemostatic molecular markers for diagnosis of disseminated intravascular coagulation in patients with infections

Hidesaku Asakura; Hideo Wada; Kohji Okamoto; Toshiaki Iba; Toshimasa Uchiyama; Yutaka Eguchi; Kazuo Kawasugi; Shin Koga; Toshihiko Mayumi; Kaoru Koike; Satoshi Gando

doi:10.1160/TH05-04-0286

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 95(02): 282-287
DOI: 10.1160/TH05-04-0286

Wound Healing and Inflammation/Infection

Schattauer GmbH

Evaluation of haemostatic molecular markers for diagnosis of disseminated intravascular coagulation in patients with infections

Hidesaku Asakura

¹Third Department of Internal Medicine, Kanazawa University, Graduate School of Medical Science, Kanazawa-city, Japan

,

Hideo Wada

²Department of Laboratory Medicine, Mie University School of Medicine, Tsu-city, Japan

,

Kohji Okamoto

³First Department of Surgery, University of Occupational and Environmental Health School of Medicine, KitaKyushu-city, Japan

,

Toshiaki Iba

⁴Department of Surgery, Juntendo University Urayasu Hospital, Urayasu-city, Japan

,

Toshimasa Uchiyama

⁵Department of Internal Medicine, Takasaki National Hospital, Takasaki-city, Japan

,

Yutaka Eguchi

⁶Department of Emergency and Critical Care Medicine, Shiga University of Medical Science, Ohtsu-city, Japan

,

Kazuo Kawasugi

⁷Department of Internal Medicine, Teikyo University, School of Medicine, Itabashi-ku, Japan

,

Shin Koga

²Department of Laboratory Medicine, Mie University School of Medicine, Tsu-city, Japan

,

Toshihiko Mayumi

⁸Department of Emergency Medicine and Intensive Care, Graduate School of Medicine, Nagoya University, Nagoya-city, Japan

,

Kaoru Koike

⁹Department of Emergency and Critical Care Medicine, Tohoku University, Graduate School of Medicine, Sendai-city, Japan

,

Satoshi Gando

¹⁰Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo-city, Japan

› Author Affiliations

Abstract

Summary

Early treatment of disseminated intravascular coagulation (DIC) is recommended but global coagulation tests used in authorized DIC criteria are not sensitive for diagnosis of early-phase DIC. We examined the plasma levels of thrombin-antithrombin complex (TAT), plasmin-plasmin inhibitor complex (PPIC) and D-dimer in patients with suspected DIC to determine the cutoff values for diagnosis of DIC. Plasma levels of D-dimer, TAT and PPIC were significantly elevated in patients with DIC and correlated with DIC score. The cutoff values were determined using the receiver operative curve analysis. The cutoff value represented the point at which the sensitivity curve crossed the specificity curve. The cutoff values of D-dimer, TAT and PPIC for DIC were 12. 0 µg/ml, 11.0 ng/ml and 1.8 µg/ml, respectively. These values were moderately to highly sensitive for the diagnosis of DIC but not for poor outcome. The combination of D-dimer, TAT and PPIC showed high sensitivity and low specificity when one or more tests were positive, but showed low sensitivity and high specificity when all three tests were positive. We conclude that hemostatic molecular markers might be useful for the diagnosis of DIC and should be confirmed by several trials.

Keywords

DIC - TAT - PPIC - D-dimer - mortality

Full Text

References

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