What is the ISTH scoring system for disseminated intravascular coagulation (DIC)?

By William Aird

The International Society on Thrombosis and Haemostasis (ISTH) scoring system was developed by the Scientific and Standardization Committee on Disseminated Intravascular Coagulation and published in 2001. It is makes use of laboratory tests available in almost all hospital laboratories.

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
Data are presented as values with number of points in parentheses. A total score of ≥5 is compatible with diagnosis of DIC

See ISTH calculator

Original publication on the ISTH score can be found here.