ArticlePediatric research2026
Comparison of diagnostic criteria for disseminated intravascular coagulation in critically ill children.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThis study aimed to assess disseminated intravascular coagulation (DIC) incidence and its correlation with pediatric intensive care unit mortality across various scoring systems to identify the most effective diagnostic approach for different subgroups of critically ill children.
methodsThis observational cohort study compared five established diagnostic criteria for DIC: the International Society on Thrombosis and Hemostasis overt DIC criteria (DIC-ISTH 2021 and 2025criteria), sepsis-induced coagulopathy criteria (SIC-ISTH and SIC-China criteria) and the Chinese DIC Scoring System.
resultsThis study of 2015 critically ill children revealed substantial variation in DIC incidence rates across diagnostic criteria, with SIC-ISTH consistently identifying the highest proportion of cases. There was excellent agreement between the 2021 and 2025 DIC-ISTH criteria and near-perfect agreement between the SIC-ISTH and SIC-China criteria, with consistent results across all subgroups. In patients with sepsis, SIC criteria exhibited higher area under the curve (AUC) and sensitivity than DIC criteria. Among patients with hematologic malignancies, mortality rates and sensitivity for mortality discrimination were comparable between SIC and DIC criteria.
conclusionsDIC incidence varies significantly depending on diagnostic criteria and clinical subgroup. SIC criteria provide the most reliable for early detection of DIC. A combination of the SIC-ISTH and DIC-ISTH (2001) criteria is recommended for screening overt-DIC in critically ill pediatric patients. IMPACT: 1. Disseminated intravascular coagulation is a life-threatening condition in pediatric critical care, strongly correlating with multiorgan dysfunction and mortality. 2. No single definition has proven superior, and a universal consensus on the most appropriate diagnostic criteria for pediatric patients remains lacking. 3. This study addresses a critical gap in pediatric critical care by systematically evaluating five established DIC diagnostic criteria in a heterogeneous PICU cohort, including sepsis and hematologic malignancy subgroups. 4. Our key findings directly align with your journal's focus on evidence-based approaches to pediatric research.
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