Which laboratory tests are most useful for monitoring the progression of DIC in a primary care setting?

In a primary care setting, the most useful laboratory tests for monitoring the progression of disseminated intravascular coagulation (DIC) include:

• Full blood count (FBC) to assess platelet levels and detect thrombocytopenia.
• Prothrombin time (PT) and activated partial thromboplastin time (APTT) to evaluate coagulation pathway abnormalities and prolongation indicative of consumption of clotting factors.
• D-dimer test to detect elevated fibrin degradation products, reflecting ongoing fibrinolysis and clot formation.
• Fibrinogen level (if available) to assess consumption of clotting factors, as fibrinogen is typically decreased in DIC.

These tests collectively help monitor the coagulation status and progression of DIC, although definitive diagnosis and management often require specialist input and hospital-based investigations.

In primary care, baseline blood tests including FBC, PT, and APTT are recommended when managing coagulation disorders and suspected thrombotic events, as per NICE guidelines on venous thromboembolism and anticoagulation monitoring ¹,³. D-dimer testing is sensitive for detecting fibrin degradation products but has low specificity and should be interpreted in clinical context ¹,³.