{"title":"血清白蛋白水平对败血症相关凝血病患者抗凝血酶补充结果的影响:一项回顾性研究。","authors":"Masatomo Ebina, Kazunori Fujino, Akira Inoue, Koichi Ariyoshi, Yutaka Eguchi","doi":"10.1177/1179545X19858361","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Severe sepsis is commonly associated with mortality among critically ill patients and is known to cause coagulopathy. While antithrombin is an anticoagulant used in this setting, serum albumin levels are known to influence serum antithrombin levels. Therefore, this study aimed to evaluate the outcomes of antithrombin supplementation in patients with sepsis-associated coagulopathy, as well as the relationship between serum albumin levels and the effects of antithrombin supplementation.</p><p><strong>Methods: </strong>This retrospective study evaluated patients who were >18 years of age and had been admitted to either of two intensive care units for sepsis-associated coagulopathy. The groups that did and did not receive antithrombin supplementation were compared for outcomes up to 1 year after admission. Subgroup analyses were performed for patients with serum albumin levels of <2.5 g/dL or ⩾2.5 g/dL.</p><p><strong>Results: </strong>Fifty-one patients received antithrombin supplementation and 163 patients did not. The Cox proportional hazards model revealed that antithrombin supplementation was independently associated with 28-day survival (hazard ratio [HR]: 0.374, <i>P</i> = 0.025) but not with 1 year survival (HR: 0.915, <i>P</i> = 0.752). In addition, among patients with serum albumin levels of <2.5 g/dL, antithrombin supplementation was associated with a significantly lower 28-day mortality rate (9.4% vs 36.8%, <i>P</i> = .009).</p><p><strong>Conclusion: </strong>Antithrombin supplementation may improve short-term survival, but not long-term survival, among patients with sepsis-associated coagulopathy.</p>","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179545X19858361","citationCount":"1","resultStr":"{\"title\":\"Effects of Serum Albumin Levels on Antithrombin Supplementation Outcomes Among Patients With Sepsis-Associated Coagulopathy: A Retrospective Study.\",\"authors\":\"Masatomo Ebina, Kazunori Fujino, Akira Inoue, Koichi Ariyoshi, Yutaka Eguchi\",\"doi\":\"10.1177/1179545X19858361\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Severe sepsis is commonly associated with mortality among critically ill patients and is known to cause coagulopathy. While antithrombin is an anticoagulant used in this setting, serum albumin levels are known to influence serum antithrombin levels. Therefore, this study aimed to evaluate the outcomes of antithrombin supplementation in patients with sepsis-associated coagulopathy, as well as the relationship between serum albumin levels and the effects of antithrombin supplementation.</p><p><strong>Methods: </strong>This retrospective study evaluated patients who were >18 years of age and had been admitted to either of two intensive care units for sepsis-associated coagulopathy. The groups that did and did not receive antithrombin supplementation were compared for outcomes up to 1 year after admission. Subgroup analyses were performed for patients with serum albumin levels of <2.5 g/dL or ⩾2.5 g/dL.</p><p><strong>Results: </strong>Fifty-one patients received antithrombin supplementation and 163 patients did not. The Cox proportional hazards model revealed that antithrombin supplementation was independently associated with 28-day survival (hazard ratio [HR]: 0.374, <i>P</i> = 0.025) but not with 1 year survival (HR: 0.915, <i>P</i> = 0.752). In addition, among patients with serum albumin levels of <2.5 g/dL, antithrombin supplementation was associated with a significantly lower 28-day mortality rate (9.4% vs 36.8%, <i>P</i> = .009).</p><p><strong>Conclusion: </strong>Antithrombin supplementation may improve short-term survival, but not long-term survival, among patients with sepsis-associated coagulopathy.</p>\",\"PeriodicalId\":43083,\"journal\":{\"name\":\"Clinical Medicine Insights-Blood Disorders\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2019-06-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1177/1179545X19858361\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Medicine Insights-Blood Disorders\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/1179545X19858361\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2019/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Medicine Insights-Blood Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/1179545X19858361","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
摘要
背景:严重脓毒症通常与危重病人的死亡率相关,并且已知会引起凝血功能障碍。虽然抗凝血酶是在这种情况下使用的抗凝血剂,血清白蛋白水平已知会影响血清抗凝血酶水平。因此,本研究旨在评价补充抗凝血酶对脓毒症相关凝血功能障碍患者的预后,以及血清白蛋白水平与补充抗凝血酶效果的关系。方法:本回顾性研究评估了年龄>18岁且因脓毒症相关凝血病入住两间重症监护病房的患者。在入院后1年内,对服用和未服用抗凝血酶的两组进行比较。结果:51例患者补充了抗凝血酶,163例患者没有补充。Cox比例风险模型显示,抗凝血酶补充与28天生存率独立相关(风险比[HR]: 0.374, P = 0.025),但与1年生存率无关(风险比:0.915,P = 0.752)。此外,患者血清白蛋白水平P = 0.009)。结论:补充抗凝血酶可以改善败血症相关凝血病患者的短期生存,但不能改善长期生存。
Effects of Serum Albumin Levels on Antithrombin Supplementation Outcomes Among Patients With Sepsis-Associated Coagulopathy: A Retrospective Study.
Background: Severe sepsis is commonly associated with mortality among critically ill patients and is known to cause coagulopathy. While antithrombin is an anticoagulant used in this setting, serum albumin levels are known to influence serum antithrombin levels. Therefore, this study aimed to evaluate the outcomes of antithrombin supplementation in patients with sepsis-associated coagulopathy, as well as the relationship between serum albumin levels and the effects of antithrombin supplementation.
Methods: This retrospective study evaluated patients who were >18 years of age and had been admitted to either of two intensive care units for sepsis-associated coagulopathy. The groups that did and did not receive antithrombin supplementation were compared for outcomes up to 1 year after admission. Subgroup analyses were performed for patients with serum albumin levels of <2.5 g/dL or ⩾2.5 g/dL.
Results: Fifty-one patients received antithrombin supplementation and 163 patients did not. The Cox proportional hazards model revealed that antithrombin supplementation was independently associated with 28-day survival (hazard ratio [HR]: 0.374, P = 0.025) but not with 1 year survival (HR: 0.915, P = 0.752). In addition, among patients with serum albumin levels of <2.5 g/dL, antithrombin supplementation was associated with a significantly lower 28-day mortality rate (9.4% vs 36.8%, P = .009).
Conclusion: Antithrombin supplementation may improve short-term survival, but not long-term survival, among patients with sepsis-associated coagulopathy.