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

Hayakawa, Mineji; Kudo, Daisuke; Saito, Shinjiro; Uchino, Shigehiko; Yamakawa, Kazuma; Iizuka, Yusuke; Sanui, Masamitsu; Takimoto, Kohei; Mayumi, Toshihiko; Ono, Kota; Azuhata, Takeo; Ito, Fumihito; Yoshihiro, Shodai; Hayakawa, Katsura; Nakashima, Tsuyoshi; Ogura, Takayuki; Noda, Eiichiro; Nakamura, Yoshihiko; Sekine, Ryosuke; Yoshikawa, Yoshiaki; Sekino, Motohiro; Ueno, Keiko; Okuda, Yuko; Watanabe, Masayuki; Tampo, Akihito; Saito, Nobuyuki; Kitai, Yuya; Takahashi, Hiroki; Kobayashi, Iwao; Kondo, Yutaka; Matsunaga, Wataru; Nachi, Sho; Miike, Toru; Takahashi, Hiroshi; Takauji, Shuhei; Umakoshi, Kensuke; Todaka, Takafumi; Kodaira, Hiroshi; Andoh, Kohkichi; Kasai, Takehiko; Iwashita, Yoshiaki; Arai, Hideaki; Murata, Masato; Yamane, Masahiro; Shiga, Kazuhiro; Hori, Naoto

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

Hayakawa, Mineji; Kudo, Daisuke; Saito, Shinjiro et al.

SHOCK, 2016, 46(6), 623-631

Permalink : https://hdl.handle.net/2115/64275

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論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/64275
タイトル	Antithrombin Supplementation and Mortality in Sepsis-Induced Disseminated Intravascular Coagulation : A Multicenter Retrospective Observational Study
著者	Hayakawa, Mineji ; Kudo, Daisuke ; Saito, Shinjiro ; Uchino, Shigehiko ; Yamakawa, Kazuma ; Iizuka, Yusuke ; Sanui, Masamitsu ; Takimoto, Kohei ; Mayumi, Toshihiko ; Ono, Kota ; Azuhata, Takeo ; Ito, Fumihito ; Yoshihiro, Shodai ; Hayakawa, Katsura ; Nakashima, Tsuyoshi ; Ogura, Takayuki ; Noda, Eiichiro ; Nakamura, Yoshihiko ; Sekine, Ryosuke ; Yoshikawa, Yoshiaki ; Sekino, Motohiro ; Ueno, Keiko ; Okuda, Yuko ; Watanabe, Masayuki ; Tampo, Akihito ; Saito, Nobuyuki ; Kitai, Yuya ; Takahashi, Hiroki ; Kobayashi, Iwao ; Kondo, Yutaka ; Matsunaga, Wataru ; Nachi, Sho ; Miike, Toru ; Takahashi, Hiroshi ; Takauji, Shuhei ; Umakoshi, Kensuke ; Todaka, Takafumi ; Kodaira, Hiroshi ; Andoh, Kohkichi ; Kasai, Takehiko ; Iwashita, Yoshiaki ; Arai, Hideaki ; Murata, Masato ; Yamane, Masahiro ; Shiga, Kazuhiro ; Hori, Naoto
e-Rad_Researcher 10374282 著者名 Hayakawa, Mineji
e-Rad_Researcher 30455844 著者名 Kudo, Daisuke
著者名 Saito, Shinjiro
著者名 Uchino, Shigehiko
著者名 Yamakawa, Kazuma
著者名 Iizuka, Yusuke
著者名 Sanui, Masamitsu
著者名 Takimoto, Kohei
著者名 Mayumi, Toshihiko
著者名 Ono, Kota
著者名 Azuhata, Takeo
著者名 Ito, Fumihito
著者名 Yoshihiro, Shodai
著者名 Hayakawa, Katsura
著者名 Nakashima, Tsuyoshi
著者名 Ogura, Takayuki
著者名 Noda, Eiichiro
著者名 Nakamura, Yoshihiko
著者名 Sekine, Ryosuke
著者名 Yoshikawa, Yoshiaki
e-Rad_Researcher 40380927 著者名 Sekino, Motohiro
著者名 Ueno, Keiko
著者名 Okuda, Yuko
著者名 Watanabe, Masayuki
e-Rad_Researcher 80531524 著者名 Tampo, Akihito
著者名 Saito, Nobuyuki
著者名 Kitai, Yuya
著者名 Takahashi, Hiroki
著者名 Kobayashi, Iwao
著者名 Kondo, Yutaka
著者名 Matsunaga, Wataru
e-Rad_Researcher 30452155 著者名 Nachi, Sho
著者名 Miike, Toru
著者名 Takahashi, Hiroshi
著者名 Takauji, Shuhei
著者名 Umakoshi, Kensuke
著者名 Todaka, Takafumi
著者名 Kodaira, Hiroshi
著者名 Andoh, Kohkichi
著者名 Kasai, Takehiko
著者名 Iwashita, Yoshiaki
著者名 Arai, Hideaki
著者名 Murata, Masato
著者名 Yamane, Masahiro
著者名 Shiga, Kazuhiro
著者名 Hori, Naoto
言語	英語
キーワード	antithrombin
	coagulation abnormality
	disseminated intravascular coagulation
	mortality
	sepsis
発行日	2016-12
出版者	Lippincott Williams & Wilkins
収録物名	SHOCK
巻(号)	46(6)
ページ	623-631
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
PISSN	1073-2322
関連情報	PMID 27548460
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1097/SHK.0000000000000727