Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption

Katsuhiko Tada; Yasunari Miyagi; Kazumasa Kumazawa; Saya Tsukahara; Naoki Okimoto; Mizuho Yoshida; Naomi Ooka

doi:doi:10.11648/j.ejcbs.20220802.14

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Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption

Katsuhiko Tada, Yasunari Miyagi, Kazumasa Kumazawa, Saya Tsukahara, Naoki Okimoto, Mizuho Yoshida, Naomi Ooka

Published in European Journal of Clinical and Biomedical Sciences (Volume 8, Issue 2)

Received: 6 April 2022 Accepted: 20 April 2022 Published: 29 April 2022

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Abstract

Objective: The diagnosis of disseminated intravascular coagulation (DIC) in obstetrics characterized by marked elevation of fibrin/fibrinogen degradation products (FDP) requires specific FDP criteria, however, no reference values are currently available. We previously reported the FDP criteria reflecting the degree of coagulation activity, determined by the quantitative relation between the distributions of FDP and fibrinogen. We aimed to evaluate the feasibility of applying the novel FDP criteria to four existing DIC diagnostic scoring systems, in a retrospective study of Japanese women with placental abruption. Materials and Methods: The study population was 68 pregnant women who had been diagnosed with placental abruption at Okayama Medical Center (Japan) between January 2008 and December 2020. DIC was clinically determined using the following four categories: plasma fibrinogen level < 100 mg/dl, hemorrhage amount at delivery ≥ 2000 g, blood product (red blood cells and fresh frozen plasma) transfusion, and renal dysfunction. Based on our previous report on the artificial intelligence analysis of the FDP distribution function, FDP criteria for the normal upper limit, moderate increase, and marked increase were defined as 20, 32, and 80 μg/ml, respectively. We applied the FDP criteria to compare four current and revised DIC diagnostic scoring systems: Japanese Ministry of Health and Welfare (JMHW), Japanese Association for Acute Medicine (JAAM), International Society on Thrombosis and Haemostasis (ISTH), and pregnancy-modified ISTH (PM-ISTH) DIC score. We used the Kruskal-Wallis test, Wilcoxon rank-sum test, and proportion test for statistical analysis. Results: Clinical DIC was observed in nine cases. Sensitivity was 1.00 in all DIC scoring systems. The current/revised sensitivity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 1.00/1.00, 1.00/1.00, not available (NA)/1.00, and 1.00/NA, respectively. The current/revised specificity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 0.864/0.864, 0.678/0.797, NA/0.864, and 0.424/NA, respectively. The specificity of the revised JMHW and revised ISTH systems was higher than for the current JAAM (P < 0.05) and current PM-ISTH (P < 0.0001) systems. The specificity of the revised JAAM improved from 0.678 to 0.797. Conclusion: Our novel proposed FDP criteria are potentially useful for diagnosis of DIC in placental abruption.

Published in	European Journal of Clinical and Biomedical Sciences (Volume 8, Issue 2)
DOI	10.11648/j.ejcbs.20220802.14
Page(s)	27-32
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Diagnostic Tests, Disseminated Intravascular Coagulation, Fibrin Fibrinogen Degradation Products, Fibrinolysis, Placental Abruption

References

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APA Style

Katsuhiko Tada, Yasunari Miyagi, Kazumasa Kumazawa, Saya Tsukahara, Naoki Okimoto, et al. (2022). Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption. European Journal of Clinical and Biomedical Sciences, 8(2), 27-32. https://doi.org/10.11648/j.ejcbs.20220802.14

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ACS Style

Katsuhiko Tada; Yasunari Miyagi; Kazumasa Kumazawa; Saya Tsukahara; Naoki Okimoto, et al. Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption. Eur. J. Clin. Biomed. Sci. 2022, 8(2), 27-32. doi: 10.11648/j.ejcbs.20220802.14

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AMA Style

Katsuhiko Tada, Yasunari Miyagi, Kazumasa Kumazawa, Saya Tsukahara, Naoki Okimoto, et al. Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption. Eur J Clin Biomed Sci. 2022;8(2):27-32. doi: 10.11648/j.ejcbs.20220802.14

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@article{10.11648/j.ejcbs.20220802.14,
  author = {Katsuhiko Tada and Yasunari Miyagi and Kazumasa Kumazawa and Saya Tsukahara and Naoki Okimoto and Mizuho Yoshida and Naomi Ooka},
  title = {Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption},
  journal = {European Journal of Clinical and Biomedical Sciences},
  volume = {8},
  number = {2},
  pages = {27-32},
  doi = {10.11648/j.ejcbs.20220802.14},
  url = {https://doi.org/10.11648/j.ejcbs.20220802.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20220802.14},
  abstract = {Objective: The diagnosis of disseminated intravascular coagulation (DIC) in obstetrics characterized by marked elevation of fibrin/fibrinogen degradation products (FDP) requires specific FDP criteria, however, no reference values are currently available. We previously reported the FDP criteria reflecting the degree of coagulation activity, determined by the quantitative relation between the distributions of FDP and fibrinogen. We aimed to evaluate the feasibility of applying the novel FDP criteria to four existing DIC diagnostic scoring systems, in a retrospective study of Japanese women with placental abruption. Materials and Methods: The study population was 68 pregnant women who had been diagnosed with placental abruption at Okayama Medical Center (Japan) between January 2008 and December 2020. DIC was clinically determined using the following four categories: plasma fibrinogen level Results: Clinical DIC was observed in nine cases. Sensitivity was 1.00 in all DIC scoring systems. The current/revised sensitivity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 1.00/1.00, 1.00/1.00, not available (NA)/1.00, and 1.00/NA, respectively. The current/revised specificity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 0.864/0.864, 0.678/0.797, NA/0.864, and 0.424/NA, respectively. The specificity of the revised JMHW and revised ISTH systems was higher than for the current JAAM (P P Conclusion: Our novel proposed FDP criteria are potentially useful for diagnosis of DIC in placental abruption.},
 year = {2022}
}

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TY  - JOUR
T1  - Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption
AU  - Katsuhiko Tada
AU  - Yasunari Miyagi
AU  - Kazumasa Kumazawa
AU  - Saya Tsukahara
AU  - Naoki Okimoto
AU  - Mizuho Yoshida
AU  - Naomi Ooka
Y1  - 2022/04/29
PY  - 2022
N1  - https://doi.org/10.11648/j.ejcbs.20220802.14
DO  - 10.11648/j.ejcbs.20220802.14
T2  - European Journal of Clinical and Biomedical Sciences
JF  - European Journal of Clinical and Biomedical Sciences
JO  - European Journal of Clinical and Biomedical Sciences
SP  - 27
EP  - 32
PB  - Science Publishing Group
SN  - 2575-5005
UR  - https://doi.org/10.11648/j.ejcbs.20220802.14
AB  - Objective: The diagnosis of disseminated intravascular coagulation (DIC) in obstetrics characterized by marked elevation of fibrin/fibrinogen degradation products (FDP) requires specific FDP criteria, however, no reference values are currently available. We previously reported the FDP criteria reflecting the degree of coagulation activity, determined by the quantitative relation between the distributions of FDP and fibrinogen. We aimed to evaluate the feasibility of applying the novel FDP criteria to four existing DIC diagnostic scoring systems, in a retrospective study of Japanese women with placental abruption. Materials and Methods: The study population was 68 pregnant women who had been diagnosed with placental abruption at Okayama Medical Center (Japan) between January 2008 and December 2020. DIC was clinically determined using the following four categories: plasma fibrinogen level Results: Clinical DIC was observed in nine cases. Sensitivity was 1.00 in all DIC scoring systems. The current/revised sensitivity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 1.00/1.00, 1.00/1.00, not available (NA)/1.00, and 1.00/NA, respectively. The current/revised specificity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 0.864/0.864, 0.678/0.797, NA/0.864, and 0.424/NA, respectively. The specificity of the revised JMHW and revised ISTH systems was higher than for the current JAAM (P P Conclusion: Our novel proposed FDP criteria are potentially useful for diagnosis of DIC in placental abruption.
VL  - 8
IS  - 2
ER  -

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Author Information

Katsuhiko Tada

Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center, Okayama, Japan
Yasunari Miyagi

Medical Data Labo, Okayama, Japan
Kazumasa Kumazawa

Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center, Okayama, Japan
Saya Tsukahara

Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center, Okayama, Japan
Naoki Okimoto

Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center, Okayama, Japan
Mizuho Yoshida

Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center, Okayama, Japan
Naomi Ooka

Department of Obstetrics and Gynecology, National Hospital Organization, Okayama Medical Center, Okayama, Japan

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APA Style

Katsuhiko Tada, Yasunari Miyagi, Kazumasa Kumazawa, Saya Tsukahara, Naoki Okimoto, et al. (2022). Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption. European Journal of Clinical and Biomedical Sciences, 8(2), 27-32. https://doi.org/10.11648/j.ejcbs.20220802.14

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ACS Style

Katsuhiko Tada; Yasunari Miyagi; Kazumasa Kumazawa; Saya Tsukahara; Naoki Okimoto, et al. Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption. Eur. J. Clin. Biomed. Sci. 2022, 8(2), 27-32. doi: 10.11648/j.ejcbs.20220802.14

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AMA Style

Katsuhiko Tada, Yasunari Miyagi, Kazumasa Kumazawa, Saya Tsukahara, Naoki Okimoto, et al. Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption. Eur J Clin Biomed Sci. 2022;8(2):27-32. doi: 10.11648/j.ejcbs.20220802.14

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@article{10.11648/j.ejcbs.20220802.14,
  author = {Katsuhiko Tada and Yasunari Miyagi and Kazumasa Kumazawa and Saya Tsukahara and Naoki Okimoto and Mizuho Yoshida and Naomi Ooka},
  title = {Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption},
  journal = {European Journal of Clinical and Biomedical Sciences},
  volume = {8},
  number = {2},
  pages = {27-32},
  doi = {10.11648/j.ejcbs.20220802.14},
  url = {https://doi.org/10.11648/j.ejcbs.20220802.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20220802.14},
  abstract = {Objective: The diagnosis of disseminated intravascular coagulation (DIC) in obstetrics characterized by marked elevation of fibrin/fibrinogen degradation products (FDP) requires specific FDP criteria, however, no reference values are currently available. We previously reported the FDP criteria reflecting the degree of coagulation activity, determined by the quantitative relation between the distributions of FDP and fibrinogen. We aimed to evaluate the feasibility of applying the novel FDP criteria to four existing DIC diagnostic scoring systems, in a retrospective study of Japanese women with placental abruption. Materials and Methods: The study population was 68 pregnant women who had been diagnosed with placental abruption at Okayama Medical Center (Japan) between January 2008 and December 2020. DIC was clinically determined using the following four categories: plasma fibrinogen level Results: Clinical DIC was observed in nine cases. Sensitivity was 1.00 in all DIC scoring systems. The current/revised sensitivity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 1.00/1.00, 1.00/1.00, not available (NA)/1.00, and 1.00/NA, respectively. The current/revised specificity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 0.864/0.864, 0.678/0.797, NA/0.864, and 0.424/NA, respectively. The specificity of the revised JMHW and revised ISTH systems was higher than for the current JAAM (P P Conclusion: Our novel proposed FDP criteria are potentially useful for diagnosis of DIC in placental abruption.},
 year = {2022}
}

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TY  - JOUR
T1  - Feasibility of Applying Novel FDP Threshold Criteria to DIC Diagnostic Scoring Systems in Japanese Women with Placental Abruption
AU  - Katsuhiko Tada
AU  - Yasunari Miyagi
AU  - Kazumasa Kumazawa
AU  - Saya Tsukahara
AU  - Naoki Okimoto
AU  - Mizuho Yoshida
AU  - Naomi Ooka
Y1  - 2022/04/29
PY  - 2022
N1  - https://doi.org/10.11648/j.ejcbs.20220802.14
DO  - 10.11648/j.ejcbs.20220802.14
T2  - European Journal of Clinical and Biomedical Sciences
JF  - European Journal of Clinical and Biomedical Sciences
JO  - European Journal of Clinical and Biomedical Sciences
SP  - 27
EP  - 32
PB  - Science Publishing Group
SN  - 2575-5005
UR  - https://doi.org/10.11648/j.ejcbs.20220802.14
AB  - Objective: The diagnosis of disseminated intravascular coagulation (DIC) in obstetrics characterized by marked elevation of fibrin/fibrinogen degradation products (FDP) requires specific FDP criteria, however, no reference values are currently available. We previously reported the FDP criteria reflecting the degree of coagulation activity, determined by the quantitative relation between the distributions of FDP and fibrinogen. We aimed to evaluate the feasibility of applying the novel FDP criteria to four existing DIC diagnostic scoring systems, in a retrospective study of Japanese women with placental abruption. Materials and Methods: The study population was 68 pregnant women who had been diagnosed with placental abruption at Okayama Medical Center (Japan) between January 2008 and December 2020. DIC was clinically determined using the following four categories: plasma fibrinogen level Results: Clinical DIC was observed in nine cases. Sensitivity was 1.00 in all DIC scoring systems. The current/revised sensitivity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 1.00/1.00, 1.00/1.00, not available (NA)/1.00, and 1.00/NA, respectively. The current/revised specificity of the JMHW, JAAM, ISTH, and PM-ISTH systems was 0.864/0.864, 0.678/0.797, NA/0.864, and 0.424/NA, respectively. The specificity of the revised JMHW and revised ISTH systems was higher than for the current JAAM (P P Conclusion: Our novel proposed FDP criteria are potentially useful for diagnosis of DIC in placental abruption.
VL  - 8
IS  - 2
ER  -

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