Summary

Early treatment of disseminated intravascular coagulation (DIC)is recommended but global coagulation tests used in authorizedDIC criteria are not sensitive for diagnosis of early-phase DIC.We examined the plasma levels of thrombin-antithrombin complex(TAT), plasmin-plasmin inhibitor complex (PPIC) andD-dimer in patients with suspected DIC to determine the cutoffvalues for diagnosis of DIC. Plasma levels of D-dimer,TAT andPPIC were significantly elevated in patients with DIC and correlatedwith DIC score.The cutoff values were determined usingthe receiver operative curve analysis. The cutoff value represented the point at which the sensitivity curve crossed the specificitycurve.The cutoff values of D-dimer,TAT and PPIC for DICwere 12.0 µ g/ml, 11.0 ng/ml and 1.8 µ g/ml, respectively. Thesevalues were moderately to highly sensitive for the diagnosis ofDIC but not for poor outcome. The combination of D-dimer,TAT and PPIC showed high sensitivity and low specificity whenone or more tests were positive, but showed low sensitivity andhigh specificity when all three tests were positive.We concludethat hemostatic molecular markers might be useful for the diagnosisof DIC and should be confirmed by several trials.