Summary
Efforts to improve the prognosis in disseminated intravascular coagulation (DIC) have
been hampered by the lack of an early, useful and rapidly available diagnostic marker.
More recently, a characteristic bi-phasic change in the light transmittance waveform
profile of the APTT assay has been associated with DIC. In this prospective study,
we have assessed the utility of this assay in the routine clinical setting. 1,470
samples were analysed from 747 patients and 41 patients had DIC. The sensitivity and
specificity of the bi-phasic waveform pattern for DIC was 97.6% and 98% respectively.
The appearance of a biphasic waveform preceded the development of abnormalities in
the standard laboratory tests for DIC and waveform changes correlated closely with
clinical events. In conclusion, transmittance waveform analysis is not only useful
as an early diagnostic and single monitoring marker of DIC but the quantifiable and
standardisable changes also allow for prognostic applicability in clinical management.
