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Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation

Persistent inflammation, immunosuppression, and catabolism syndrome (PICS) is a serious condition after critical care. We examined the efficacy of antithrombin, which may attenuate coagulopathy with the control of inflammation, for PICS among patients with sepsis-induced disseminated intravascular c...

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Autores principales: Kanda, Naoki, Ohbe, Hiroyuki, Nakamura, Kensuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253515/
https://www.ncbi.nlm.nih.gov/pubmed/37298017
http://dx.doi.org/10.3390/jcm12113822
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author Kanda, Naoki
Ohbe, Hiroyuki
Nakamura, Kensuke
author_facet Kanda, Naoki
Ohbe, Hiroyuki
Nakamura, Kensuke
author_sort Kanda, Naoki
collection PubMed
description Persistent inflammation, immunosuppression, and catabolism syndrome (PICS) is a serious condition after critical care. We examined the efficacy of antithrombin, which may attenuate coagulopathy with the control of inflammation, for PICS among patients with sepsis-induced disseminated intravascular coagulation (DIC). The present study used the inpatient claims database with laboratory findings to identify patients admitted to intensive care units and diagnosed with sepsis and DIC. A composite of the incidence of PICS on day 14 or 14-day mortality as the primary outcome was compared between the antithrombin and control groups using a propensity-score-matched analysis. Secondary outcomes were the incidence of PICS on day 28, 28-day mortality, and in-hospital mortality. A total of 324 well-balanced matched pairs were generated from 1622 patients. The primary outcome did not differ between the antithrombin and control groups (63.9% vs. 68.2%, respectively, p = 0.245). However, the incidences of 28-day and in-hospital mortality were significantly lower in the antithrombin group (16.0% vs. 23.5% and 24.4% vs. 35.8%, respectively). Similar results were obtained in a sensitivity analysis using overlap weighting. Antithrombin did not reduce the occurrence of PICS on day 14 in patients with sepsis-induced DIC; however, it was associated with a better mid-term (day 28) prognosis.
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spelling pubmed-102535152023-06-10 Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation Kanda, Naoki Ohbe, Hiroyuki Nakamura, Kensuke J Clin Med Article Persistent inflammation, immunosuppression, and catabolism syndrome (PICS) is a serious condition after critical care. We examined the efficacy of antithrombin, which may attenuate coagulopathy with the control of inflammation, for PICS among patients with sepsis-induced disseminated intravascular coagulation (DIC). The present study used the inpatient claims database with laboratory findings to identify patients admitted to intensive care units and diagnosed with sepsis and DIC. A composite of the incidence of PICS on day 14 or 14-day mortality as the primary outcome was compared between the antithrombin and control groups using a propensity-score-matched analysis. Secondary outcomes were the incidence of PICS on day 28, 28-day mortality, and in-hospital mortality. A total of 324 well-balanced matched pairs were generated from 1622 patients. The primary outcome did not differ between the antithrombin and control groups (63.9% vs. 68.2%, respectively, p = 0.245). However, the incidences of 28-day and in-hospital mortality were significantly lower in the antithrombin group (16.0% vs. 23.5% and 24.4% vs. 35.8%, respectively). Similar results were obtained in a sensitivity analysis using overlap weighting. Antithrombin did not reduce the occurrence of PICS on day 14 in patients with sepsis-induced DIC; however, it was associated with a better mid-term (day 28) prognosis. MDPI 2023-06-02 /pmc/articles/PMC10253515/ /pubmed/37298017 http://dx.doi.org/10.3390/jcm12113822 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kanda, Naoki
Ohbe, Hiroyuki
Nakamura, Kensuke
Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation
title Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation
title_full Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation
title_fullStr Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation
title_full_unstemmed Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation
title_short Effects of Antithrombin on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome among Patients with Sepsis-Induced Disseminated Intravascular Coagulation
title_sort effects of antithrombin on persistent inflammation, immunosuppression, and catabolism syndrome among patients with sepsis-induced disseminated intravascular coagulation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253515/
https://www.ncbi.nlm.nih.gov/pubmed/37298017
http://dx.doi.org/10.3390/jcm12113822
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