Prospective Evaluation Of New Chinese Diagnostic Scoring System For Disseminated Intravascular Coagulation

Objectives To prospectively validate the new Chinese disseminated intravascular coagulation scoring system (CDICS) by comparing it with Japanese Ministry of Health and Welfare (JMHW) and International Society on Thrombosis and Hemostasis (ISTH) Overt DIC scoring system.Materials and Methods This study prospectively collected the blood samples and clinical information on day 1,2,3 and 7 of 33 patients who were suspected of Disseminated Intravenous Coagulation in Qilu Hospital of Shandong University during 2015-07 to 2016-01. Then calculated their daily DIC scores by CDICS, JMHW and ISTH overt DIC scoring system and SOFA scores. All patients were followed up to the 28th day. We evaluated the diagnostic property of CDICS by comparing it with two leading scoring systems, JMHW and ISTH Overt DIC criteria and its prognosis by 28th day mortality. We also investigated the abnormalities of mean values of PT, APTT, FIB and D-Dimer between CDICS DIC(+) and DIC(-).Results The grade of agreement between the Chinese and International system in the diagnosis of DIC was 73.7%. The grade of agreement between the Chinese and the Japanese system in the diagnosis of DIC was 94.7%.The diagnostic sensitivity of CDICS, JMHW and ISTH Overt criteria is 57.58%,72.73% and 42.42% respectively. The 28th day mortality is 31.58%,29.17%,35.71% respectively. The death sensitivity is 85.71%,100%, and 71.43% respectively. The death specificity is 50%,34.62%, 65.38% respectively. For fibrinogen levels, more than 70% of DIC and 100% of non-DIC by CDICS scored 0 point. For platelet and D-dimer, more than 80%of DIC and about 40% non-DIC by CDICS showed abnormalities. In addition, the 28-day mortality rate of DIC patients diagnosed by CDICS were significantly greater than non-DIC (P<0.05).Conclusions Among the three criteria, the death sensitivity of JMHW is the highest, the 28-day mortality and death specificity of ISTH Overt criteria is the highest. All the evaluated indicators of CDICS are between the highest and the lowest value. In this study we can see that CDICS showed an acceptable property for the diagnosis of DIC with appropriate sensitivity and specificity, and also had a good prognostic value for DIC patients.This study is a single-center, small sample statistical analysis. Conclusions need to be further confirmed by multi-center, prospective study.