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Article
October 1986

Diagnostic Efficacy of Six Plasma Proteins in Evaluating Consumptive Coagulopathies: Use of Receiver Operating Characteristic Curves to Compare Antithrombin III, Plasminogen, a2-Plasmin Inhibitor, Fibronectin, Prothrombin, and Protein C

Author Affiliations

From the Departments of Pathology and Laboratory Medicine (Dr Cembrowski) and Medicine (Dr Mosher), University of Wisconsin, Madison and the Department of Molecular Immunology (Dr Griffin), Scripps Clinic and Research Foundation, La Jolla, Calif. Dr Cembrowski is now with the Hospital of the University of Pennsylvania, Philadelphia.

Arch Intern Med. 1986;146(10):1997-2002. doi:10.1001/archinte.1986.00360220159027
Abstract

• Six coagulation proteins were measured in 79 consecutive patients referred to the coagulation service for suspected disseminated intravascular coagulation. Antithrombin III, plasminogen, and α2-plasmin inhibitor were measured with fluorescent substrate assays. Fibronectin, prothrombin, and protein C were measured with electroimmunoassays. Using history and physical findings and the results of a coagulation screen (prothrombin time, partial thromboplastin time, fibrinogen, fibrin[ogen] degradation products, platelet count, and peripheral smear), the 79 patients were classified into five categories: no disseminated intravascular coagulation (n = 21), elevated fibrin(ogen) degradation products without other evidence of coagulopathy (n = 44), defibrination syndrome (n = 9), microangiopathic thrombocytopenic purpura (n = 4), and primary fibrinolysis (n = 1). Because the sensitivity and specificity of each of the proteins could not easily be compared, receiver operating characteristic (ROC) curves and areas under the ROC curves were calculated for each of the six proteins as well as for the tests of the coagulation screen. The ROC curves indicated that, apart from plasminogen, the other coagulation proteins provided little additional information about the classification of the coagulopathy.

(Arch Intern Med 1986;146:1997-2002)

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