• Kohji Okamoto, Hideo Wada, Tsuyoshi Hatada, Toshimasa Uchiyama, Kazuo Kawasugi, Toshihiko Mayumi, Satoshi Gando, Shigeki Kushimoto, Yoshinobu Seki, Seiji Madoiwa, Hidesaku Asakura, Shin Koga, Toshiaki Iba, Ikuro Maruyama, and Japanese Society of Thrombosis Hemostasis/DIC subcommittee.
• First Department of Surgery, University of Occupational and Environmental Health School of Medicine, KitaKyushu, Japan.
• Thromb. Res. 2010 Jul 1; 126 (1): 74-8.

AbstractDisseminated intravascular coagulation (DIC) sometimes has a poor outcome, and therefore early diagnosis and treatment are required. This study prospectively evaluated the hemostatic abnormalities and the onset of DIC in 613 patients with underlying diseases to identify a useful marker for diagnosing Pre-DIC. Pre-DIC was defined as the condition of patients within a week before the onset of DIC. Initially, 34.4% of patients were diagnosed with DIC, and about 8.5% of the patients without DIC were diagnosed as DIC within a week after registration (pre-DIC). The mortality of DIC, Pre-DIC and "without DIC" was 35.3%, 32.4% and 17.2%, respectively. All hemostatic parameters were significantly worse in "DIC" than "without DIC" and the values of the prothrombin time ratio, platelet count and fibrin monomer complex could classify the three groups; "DIC", "pre-DIC" and "without DIC". No useful marker was identified that provided an adequate cutoff value to differentiate "pre-DIC" from "without DIC". A multivariate analysis identified clinical symptoms that were related to poor outcome. DIC must be treated immediately; there is no specific marker to identify pre-DIC.Copyright (c) 2010 Elsevier Ltd. All rights reserved.

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