Abstract

INTERNATIONAL SOCIETY ON THROMBOSIS AND HAEMOSTASIS DISSEMINATED INTRAVASCULAR COAGULATION SCORING SYSTEM: IS IT A GOOD PROGNOSTIC INDICATOR IN DIC

Author(s):Nisal Amit, Nimbargi Ravindra, Shelke Parineeta, Kelkar Anjali

Background: Disseminated intravascular coagulation is an acquired disorder characterized by intravascular activation of coagulation due to variety of causes. There is excessive thrombin formation leading to fibrin deposition in microcirculation and consequent ischemic organ damage. The diagnosis is essentially clinical supported by laboratory parameters and a scoring system based on these. The mainstay of treatment is correction of underlying cause and haemostatic support with replacement of coagulation factors. Aim: To evaluate the use of ISTH DIC scoring system in patients of clinically suspected Disseminated Intravascular Coagulation. Methods: 60 cases were studied over a period of one year. Patients were selected with a clinical suspicion of DIC who are having an underlying predisposing condition. Clinical signs and symptoms were recorded. Routine investigations and the tests necessary to calculate the ISTH score i.e. platelet count, Prothrombin time; D-dimer and Fibrinogen were done. The scoring criteria of ISTH were applied in these cases. Chi square and Fisher’s exact tests were used for analysis of the data. Results: The commonest cause of the underlying disorder in our study was found to be Sepsis (66.7%) followed by trauma (10%), obstetric causes (8.3%) and solid malignancy (6.7%). There was a significant association of ISTH score with outcome of the patients (P value <0.05). Raised APTT and presence of schistocytes also had a significant association with a high ISTH score. Conclusion: ISTH DIC scoring criteria more precisely define clinical and laboratory parameters of DIC. Its clinical utility will improve the timely diagnosis, prediction of severity and will also aid in improving prognosis of DIC patients.

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