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Predictability of disseminated intravascular coagulation based on the decrease rate of platelets
Critical Care volume 8, Article number: P112 (2004)
To investigate whether the decrease rate of platelets is useful for early diagnosis of disseminated intravascular coagulation (DIC).
Subjects and methods
A retrospective clinical study was performed in 454 consecutive patients who were admitted to our intensive critical care unit between 1 June and 1 October 2003. The patients whose platelet count decreased to be less than 10 × 104/μl during the course of a disease were regarded to be in a state of pre-DIC, and the relation between the subsequent decrease rate of platelets (ΔPLT) and the occurrence of DIC was investigated. ΔPLT was obtained as follows: (platelet count when platelets started to decrease - minimum platelet count subsequently observed / the number of days required to observe the minimum platelet count after platelets started to decrease).
The platelet count decreased to be less than 10 × 104/μl in 41 out of 454 patients during their hospital stay. Among these 41 patients, 28 (70%) developed DIC. There was no significant difference in age, sex, APACHE II score, SOFA score, or frequency of systemic inflammatory response syndrome between DIC and non-DIC patients. When the platelet count, the International Normalised Ratio, the fibrinogen level, the fibrin/fibrinogen degradation product (FDP) value, and the most abnormal white blood cell count in non-DIC patients were compared with those observed at the time of DIC onset in DIC patients, only the FDP value was significantly higher in DIC patients (non-DIC:DIC, 8.49 ± 3.40 μg/ml:59.6 ± 86.2 μg/ml; P < 0.05). ΔPLT was significantly higher in DIC patients (6.55 ± 8.41/μl/day) than in non-DIC patients ([2.24 ± 1.87] × 104/μl/day).
The patients who had less than 10 × 104/μl platelets and whose platelets decreased by 6.55 × 104/μl/day on average had a strong possibility to develop DIC.
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Miyauchi, H., Hagiwara, A., Murata, A. et al. Predictability of disseminated intravascular coagulation based on the decrease rate of platelets. Crit Care 8 (Suppl 1), P112 (2004). https://doi.org/10.1186/cc2579