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Recombinant human soluble thrombomodulin and mortality in sepsis-induced disseminated intravascular coagulation : a multicentre retrospective study

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タイトル: Recombinant human soluble thrombomodulin and mortality in sepsis-induced disseminated intravascular coagulation : a multicentre retrospective study
その他のタイトル: rhTM and mortality in sepsis-induced DIC
著者: Hayakawa, Mineji 著作を一覧する
Yamakawa, Kazuma 著作を一覧する
Saito, Shinjiro 著作を一覧する
Uchino, Shigehiko 著作を一覧する
Kudo, Daisuke 著作を一覧する
Iizuka, Yusuke 著作を一覧する
Sanui, Masamitsu 著作を一覧する
Takimoto, Kohei 著作を一覧する
Mayumi, Toshihiko 著作を一覧する
Ono, Kota 著作を一覧する
Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study group 著作を一覧する
キーワード: sepsis
disseminated intravascular coagulation
coagulation abnormality
mortality
thrombomodulin
発行日: 2016年 6月
出版者: Schattauer Publishers
誌名: Thrombosis and Haemostasis
巻: 115
号: 6
開始ページ: 1157
終了ページ: 1166
出版社 DOI: 10.1160/TH15-12-0987
抄録: Recombinant human soluble thrombomodulin (rhTM) is a novel class of anticoagulants for treating disseminated intravascular coagulation (DIC). Although rhTM is widely used in clinical settings throughout Japan, there is limited clinical evidence supporting the use of rhTM in patients with sepsis-induced DIC. Furthermore, rhTM is not approved for DIC treatment in other countries. This study aimed to clarify the survival benefits of rhTM administration in critically ill patients. Data from 3,195 consecutive adult patients who were admitted to 42 intensive care units for the treatment of severe sepsis or septic shock between January 2011 and December 2013 were retrospectively analysed, and 1,784 patients were diagnosed with DIC based on the scoring algorithm from the Japanese Association for Acute Medicine DIC (n = 645, rhTM group; n = 1,139, control group). Propensity score matching created 452 matched pairs, and logistic regression analysis revealed a significant association between rhTM administration and lower in-hospital all-cause mortality in the propensity score-matched groups (odds ratio, 0.757; 95% CI, 0.574-0.999, P = 0.049). Inverse probability of treatment weighted and quintile-stratified analyses also revealed significant associations between rhTM administration and lower in-hospital all-cause mortality. Survival time in the propensity score-matched rhTM group was significantly longer than that in the propensity score-matched control group (hazard ratio, 0.781; 95% CI, 0.624-0.977, P = 0.03). Bleeding complications were not more frequent in the rhTM groups. In conclusion, this study demonstrated that rhTM administration is associated with reduced in-hospital all-cause mortality among patients with sepsis-induced DIC.
Rights: This article is not an exact copy of the original published article in Thrombosis and Haemostasis. The definitive publisher-authenticated version of Thromb Haemost 2016; 115: 1157–1166 is available online at: http://dx.doi.org/10.1160/TH15-12-0987
資料タイプ: article (author version)
URI: http://hdl.handle.net/2115/65839
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 早川 峰司

 

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