The International Society on Thrombosis and Haemostasis (ISTH) scoring system for disseminated intravascular coagulation (DIC) is simple! It consists of just 4 parameters based on widely available, routine coagulation tests.

Fibrinogen (g/L)>1 (0)
<1 (1)
Overall sensitivity of low fibrinogen level reported to be about 30%.
Prothrombin time (PT) (seconds)<3 (0)
3-6 (+1)
>6 (+2)
Elevated in 50%-60% of patients with DIC at some point during course of illness.
Platelet count (109/L)>100 (0)
50-100 (+1)
<50 (+2)
Thrombocytopenia reported to occur in up to 98% of DIC cases.
D-dimers or FDPsNo increase (0)
Moderate increase (+2)
Severe increase (+3)
Elevated FDPs and D-dimers are sensitive, but not specific for DIC.
DIC, disseminated intravascular coagulation; FDP, fibrin degradation product.

Data are presented as values with number of points in parentheses.

A total score of ≥5 is compatible with diagnosis of DIC.

To reiterate, DIC is diagnosed when the ISTH DIC score is 5 or higher:

Learn more about the ISTH DIC score:

  • Original publication on the ISTH score can be found here.
  • Prospective validation study can be found here – sensitivity of the DIC score 95%, specificity 98%.
  • See ISTH calculator.
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