論文

査読有り 国際誌
2020年

Analysis of the association between resolution of disseminated intravascular coagulation (DIC) and treatment outcomes in post-marketing surveillance of thrombomodulin alpha for DIC with infectious disease and with hematological malignancy by organ failure.

Thrombosis journal
  • Noriaki Kawano
  • Hideo Wada
  • Toshimasa Uchiyama
  • Kazuo Kawasugi
  • Seiji Madoiwa
  • Naoki Takezako
  • Kei Suzuki
  • Yoshinobu Seki
  • Takayuki Ikezoe
  • Tsuyoshi Hattori
  • Kohji Okamoto
  • 全て表示

18
開始ページ
2
終了ページ
2
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1186/s12959-020-0216-6

Background: Although disseminated intravascular coagulation (DIC) is life-threatening, any organ failure associated with DIC resolution and outcomes have been unclear. Patients and methods: A total of 2795 DIC patients (infection: 1990, hematological malignancy: 805) were analyzed in the post-marketing surveillance of thrombomodulin alpha (TM-α). The background factors of sequential organ failure assessment (SOFA) and antithrombin (AT) were investigated in DIC with infectious disease for their association with DIC resolution and outcome using κ statistics, indicating DIC resolution and survival or DIC non-resolution and non-survival. The same analyses were performed for total bilirubin, creatinine, lactate dehydrogenase, and underlying disease in DIC with hematological malignancy. Results: In DIC with infectious disease, higher SOFA score severity was closely correlated with lower overall survival in both the DIC resolution and non-resolution groups, but AT activity was not. κ coefficients were 0.234, 0.295, and 0.311 for the SOFA score 0-6, 7-12, and 13-24 groups, respectively. In DIC with hematological malignancy, κ coefficients of total bilirubin were 0.251 and 0.434, and those of creatinine were 0.283 and 0.437 in the normal and abnormal groups, respectively, showing better concordance in the abnormal group than in the normal. Other factors had poor concordance. Conclusion: In DIC with infectious disease, DIC resolution is an important therapeutic target in patients who have higher SOFA score severity. In DIC with hematological malignancy, DIC resolution is similarly important in patients with abnormality of bilirubin and/or creatinine. Trial registration: The clinical characteristics and treatment outcomes of patients with DIC treated with TM-α between May 2008 and April 2010 were retrospectively analyzed by subgroup analysis of the post-marketing surveillance data.

リンク情報
DOI
https://doi.org/10.1186/s12959-020-0216-6
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32047363
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006199
ID情報
  • DOI : 10.1186/s12959-020-0216-6
  • PubMed ID : 32047363
  • PubMed Central 記事ID : PMC7006199

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