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Antithrombin Supplementation and Mortality in Sepsis-Induced Disseminated Intravascular Coagulation : A Multicenter Retrospective Observational Study

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Please use this identifier to cite or link to this item:http://hdl.handle.net/2115/64275

Title: Antithrombin Supplementation and Mortality in Sepsis-Induced Disseminated Intravascular Coagulation : A Multicenter Retrospective Observational Study
Authors: Hayakawa, Mineji Browse this author →KAKEN DB
Kudo, Daisuke Browse this author →KAKEN DB
Saito, Shinjiro Browse this author
Uchino, Shigehiko Browse this author
Yamakawa, Kazuma Browse this author
Iizuka, Yusuke Browse this author
Sanui, Masamitsu Browse this author
Takimoto, Kohei Browse this author
Mayumi, Toshihiko Browse this author
Ono, Kota Browse this author
Azuhata, Takeo Browse this author
Ito, Fumihito Browse this author
Yoshihiro, Shodai Browse this author
Hayakawa, Katsura Browse this author
Nakashima, Tsuyoshi Browse this author
Ogura, Takayuki Browse this author
Noda, Eiichiro Browse this author
Nakamura, Yoshihiko Browse this author
Sekine, Ryosuke Browse this author
Yoshikawa, Yoshiaki Browse this author
Sekino, Motohiro Browse this author →KAKEN DB
Ueno, Keiko Browse this author
Okuda, Yuko Browse this author
Watanabe, Masayuki Browse this author
Tampo, Akihito Browse this author →KAKEN DB
Saito, Nobuyuki Browse this author
Kitai, Yuya Browse this author
Takahashi, Hiroki Browse this author
Kobayashi, Iwao Browse this author
Kondo, Yutaka Browse this author
Matsunaga, Wataru Browse this author
Nachi, Sho Browse this author →KAKEN DB
Miike, Toru Browse this author
Takahashi, Hiroshi Browse this author
Takauji, Shuhei Browse this author
Umakoshi, Kensuke Browse this author
Todaka, Takafumi Browse this author
Kodaira, Hiroshi Browse this author
Andoh, Kohkichi Browse this author
Kasai, Takehiko Browse this author
Iwashita, Yoshiaki Browse this author
Arai, Hideaki Browse this author
Murata, Masato Browse this author
Yamane, Masahiro Browse this author
Shiga, Kazuhiro Browse this author
Hori, Naoto Browse this author
Keywords: antithrombin
coagulation abnormality
disseminated intravascular coagulation
mortality
sepsis
Issue Date: Dec-2016
Publisher: Lippincott Williams & Wilkins
Journal Title: SHOCK
Volume: 46
Issue: 6
Start Page: 623
End Page: 631
Publisher DOI: 10.1097/SHK.0000000000000727
PMID: 27548460
Abstract: Supplemental doses of antithrombin (AT) are widely used to treat sepsis-induced disseminated intravascular coagulation (DIC) in Japan. However, evidence on the benefits of AT supplementation for DIC is insufficient. This multicenter retrospective observational study aimed to clarify the effect of AT supplementation on sepsis-induced DIC using propensity score analyses. Data from 3,195 consecutive adult patients admitted to 42 intensive care units for severe sepsis treatment were retrospectively analyzed; 1,784 patients were diagnosed with DIC (n=715, AT group; n=1,069, control group). Inverse probability of treatment-weighted propensity score analysis indicated a statistically significant association between AT supplementation and lower in-hospital all-cause mortality (n=1,784, odds ratio [95% confidence intervals]: 0.748 [0.572-0.978], P=0.034). However, quintile-stratified propensity score analysis (n=1,784, odds ratio: 0.823 [0.646-1.050], P=0.117) and propensity score matching analysis (461 matching pairs, odds ratio: 0.855 [0.649-1.125], P=0.263) did not show this association. In the early days after intensive care unit admission, the survival rate was statistically higher in the propensity score-matched AT group than in the propensity score-matched control group (P=0.007). In DIC patients without concomitant heparin administration, similar results were observed. In conclusion, AT supplementation may be associated with reduced in-hospital all-cause mortality in patients with sepsis-induced DIC. However, the statistical robustness of this connection was not strong. In addition, although the number of transfusions needed in patients with AT supplementation increased, severe bleeding complications did not.
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article
URI: http://hdl.handle.net/2115/64275
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 早川 峰司

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