The authors observed diagnostic efficacy of D-dimer assay and
fibrinogen/fibrin
degradation products(FDP) in two groups of patients referred to the coagulation service
for suspected disseminated intravascular coagulation(DIC). One group (n= 373) included
the serum FDP results and the other group(n=483) included the plasma D-dimer results
as DIC screens in addition to other parameters such as platelet count, prothrombin time,
and fibrinogen. The scoring system based on clinical conditions(etiology, bleeding, organ
failure), and results of DIC screens were used to make diagnosis of DIC. Sensitivity,
specificity, and overall percentage accuracy as well as positive and negative predictive
values were observed using receiver operating characteristic method, which takes the
variability of diagnostic criterion levels into account. D-dimer measurement was
extremely sensitive but not specific at the diagnostic level of 0.5 μg/ml(fibrinogen
equivalent unit). FDP measurement was less sensitive but highly specific at the
diagnostic level of 40 μg/ml. We have concluded that the most helpful criterion in
making the diagnosis of DIC is positivity of both D-dimer and FDP at the diagnostic
levels of 0.5μg/ml and 40 μg/ml, respectively, in a patient at risk for DIC.
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