Abstract | BACKGROUND: METHODS: We analyzed data from 819 septic patients who had received recombinant thrombomodulin. The relationships between the 28-day mortality rate and baseline laboratory and clinical parameters were examined using univariate and multivariate analyses, and the impact of replacing the SIRS criteria with antithrombin activity was evaluated. RESULTS: The SIRS score, prothrombin time ratio, and antithrombin activity were associated with the 28-day mortality rate (P values = 0.013, 0.018, and 0.003, respectively, by multivariate analysis). A modified version of the JAAM- DIC diagnostic criteria using an antithrombin activity <70 % was capable of diagnosing the identical number (n = 706) and a similar severity of patients (mortality, 34.6 % versus 34.8 %). CONCLUSION: Since anticoagulant therapy is expected to be more effective in patients with more severe coagulation disorders, the modified version of the JAAM- DIC diagnostic criteria might be useful for discriminating patients with sepsis who are good candidates for anticoagulant therapy.
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Authors | Toshiaki Iba, Marcello Di Nisio, Jecko Thachil, Hideo Wada, Hidesaku Asakura, Koichi Sato, Naoya Kitamura, Daizoh Saitoh |
Journal | Critical care (London, England)
(Crit Care)
Vol. 20
Pg. 287
(Sep 14 2016)
ISSN: 1466-609X [Electronic] England |
PMID | 27629997
(Publication Type: Journal Article)
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Chemical References |
- Anticoagulants
- Thrombomodulin
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Topics |
- Aged
- Aged, 80 and over
- Anticoagulants
(administration & dosage, therapeutic use)
- Critical Care
(organization & administration)
- Disseminated Intravascular Coagulation
(diagnosis)
- Female
- Guidelines as Topic
- Hospital Mortality
- Humans
- Male
- Middle Aged
- Sepsis
(diagnosis)
- Societies, Medical
(organization & administration)
- Surveys and Questionnaires
- Thrombomodulin
(administration & dosage, therapeutic use)
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