Use of recombinant human soluble thrombomodulin in patients with sepsis-induced disseminated intravascular coagulation after intestinal perforation

Frontiers in Medicine
Takashi TagamiHideo Yasunaga

Abstract

Anticoagulant therapy has been evaluated with respect to its potential usefulness in reducing the high mortality rates associated with severe sepsis, including sepsis-induced disseminated intravascular coagulation (DIC) after intestinal perforation. We examined the hypothesis that recombinant human soluble thrombomodulin (rhTM) is effective in the treatment of patients with septic shock with sepsis-induced DIC after laparotomy for intestinal perforation. We performed propensity-score and instrumental variable analyses of the Japanese Diagnosis Procedure Combination in-patient database, a nationwide administrative database. The main outcome was 28-day in-hospital all-cause mortality. We categorized eligible patients (n = 2202) from 622 hospitals into the rhTM group (n = 726) and control group (n = 1476). Propensity-score matching created 621 matched pairs of patients with and without rhTM. There was neither significant difference in 28-day mortality between the two groups in the unmatched analysis (rhTM vs. control, 25.3 vs. 23.4%, respectively; difference, 1.9%; 95% CI, -1.9 to 5.7) nor in the propensity-score-matched analysis (rhTM vs. control, 26.1 vs. 24.8%, respectively; difference, 1.3%; 95% CI, -3.6 to 6.1). The logistic ...Continue Reading

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Citations

Sep 26, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Takashi TagamiHideo Yasunaga
Apr 18, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Takashi TagamiHideo Yasunaga
Jul 28, 2016·The American Journal of Emergency Medicine·Chao ZhangZhaohui Tong
May 23, 2019·Frontiers in Immunology·Felix HaussnerMarkus Huber-Lang

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Clinical Trials Mentioned

NCT01598831

Software Mentioned

SE
Stata
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