- Poster presentation
- Open Access
Predictability of disseminated intravascular coagulation based on the decrease rate of platelets
© BioMed Central Ltd. 2004
- Published: 15 March 2004
- Platelet Count
- International Normalise Ratio
- Systemic Inflammatory Response Syndrome
- Disseminate Intravascular Coagulation
- Decrease Rate
To investigate whether the decrease rate of platelets is useful for early diagnosis of disseminated intravascular coagulation (DIC).
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.