Disseminated intravascular coagulation (
DIC) is a frequent complication in
sepsis. Once patients develop
DIC, the mortality rate increases significantly. Moreover, recent studies have suggested that coagulation disorder plays a significant role in the development of organ dysfunction in
sepsis. Thus, the early detection of
DIC is vital in
sepsis care, and the Japanese Association for Acute Medicine established a set of original diagnostic criteria in 2006 (JAAM
DIC). Since then, the usefulness of the JAAM
DIC has been repeatedly reported, and these criteria have been widely adopted in emergency and
critical care settings in Japan. Different criteria have also been released by the International Society on
Thrombosis and Haemostasis (ISTH overt-
DIC), and the latter criteria are presently considered to be the international standard. Compared with the JAAM
DIC, the ISTH overt-
DIC criteria are stricter and the timing of diagnosis is later. This discrepancy is because of conceptual differences. As many physicians think
sepsis-associated
DIC is the target of
anticoagulant therapies in Japan, the JAAM
DIC criteria were designed to allow the early initiation of treatment. As other countries do not provide
DIC-specific treatments, early diagnosis is not necessary, and this situation has led to a significant gap. However, as overt-
DIC is a late-phase coagulation disorder, a need for early detection has been advocated, and members of the ISTH have recently proposed the category of
sepsis-induced coagulopathy. In this review, we introduce the strengths and weaknesses of the major criteria including JAAM-
DIC, ISTH overt-
DIC,
sepsis-induced coagulopathy, and Japanese Society on
Thrombosis and Haemostasis-
DIC.