Table 1. Scoring templates for overt- and non-overt (NO) disseminated intravascular coagulation (DIC) in patients with hemorrhagic fever with renal syndrome.
Score | DIC1 | DIC2 | DIC3a | DIC4b | Score | NO-DIC1 | NO-DIC2 | |
Platelet count, 109/L | 2 | <50 | <50 | <50 | <50 | 1 | <100 | |
1 | 50–100 | 50–100 | 50–100 | 50–100 | 0 | >100 | ||
0 | >100 | >100 | >100 | >100 | ||||
D-dimer, mg/L | 3 | >2.0 | >2.48 | >2.0 | >2.48 | 1 | ≥0.2 | ≥0.64 |
2 | 0.2–2.0 | 0.64–2.48 | 0.2–2.0 | 0.64–2.48 | 0 | <0.2 | <0.64 | |
0 | <0.2 | <0.64 | <0.2 | <0.64 | ||||
PK-INR c | 2 | >1.4 | >1.4 | >1.4 | >1.4 | 1 | ≥1.2 | |
1 | 1.2–1.4 | 1.2–1.4 | 1.2–1.4 | 1.2–1.4 | 0 | <1.2 | ||
0 | <1.2 | <1.2 | <1.2 | <1.2 | ||||
Fibrinogen, g/L | 1 | <1.0 | <1.0 | |||||
0 | ≥1.0 | ≥1.0 | ||||||
Fibrinogen/CRP-ratio | 1 | <104 | <104 | Falling values add 1 point and rising | ||||
0 | ≥104 | ≥104 | values subtract 1 point for PK and | |||||
D-dimer (vice versa for platelets) |
DIC1 and NO-DIC1 correspond to standard ISTH scoring using local decision limit. DIC—2 and NO-DIC-2 uses D-dimer cut-offs based on ICU-patients. DIC3-4 are corrected with a fibrinogen/CRP-ratio instead of fibrinogen.
The original ISTH SSC template uses “moderately” and “strongly” increased values for D-dimer cutoffs [35]. In this table laboratory cutoffs are set from local decision limits and also corrected with a fibrinogen/CRP ratio [37]. Overt DIC-score ≥5p: compatible with overt DIC, <5p: suggestive for non-overt DIC.
D-dimer cutoff as in DIC1, fibrinogen corrected with fibrinogen/CRP-ratio.
D-dimer cutoff as in DIC2, fibrinogen corrected with fibrinogen/CRP-ratio.
PK-INR <1.2 was equal to PT-prolongation <3 sec, a value between 1.2 and 1.4 was equal to PT-prolongation >3 but <6 sec, and values >1.4 were equal to PT-prolongation >6 sec.