| アブストラクト | OBJECTIVE: Acute pancreatitis (AP) complicated by disseminated intravascular coagulation (DIC) is associated with high mortality. Although recombinant human soluble thrombomodulin (rTM) is commonly used in clinical practice, its association with outcomes in AP has not been established. DESIGN: A nationwide, propensity score-matched, retrospective cohort study. SETTING: The Japanese Diagnosis Procedure Combination national inpatient database. PATIENTS: Adult patients hospitalized with AP and DIC between July 2010 and March 2022, who survived at least 3 days. Patients were divided into those receiving rTM within three days of admission and those who did not. Propensity score matching compared in-hospital mortality. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The analysis included 10,238 patients with AP and DIC, of whom 2,001 (19.5%) received rTM and 8,237 (80.5%) did not. Propensity score matching yielded 1,868 well-balanced pairs. In-hospital mortality was lower in the rTM group (15.5% [290/1,868]) compared with the non-rTM group (19.7% [368/1,868]; risk difference: -4.2%, 95% CI, -6.6% to -1.7%; risk ratio: 0.79, 95% CI, 0.69 to 0.91). CONCLUSIONS: Administration of rTM in patients with AP complicated by DIC was associated with lower in-hospital mortality. |
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| ジャーナル名 | Critical care medicine |
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| Pubmed追加日 | 2026/1/5 |
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| 投稿者 | Okada, Haruka; Horibe, Masayasu; Sasabuchi, Yusuke; Bazerbachi, Fateh; Kayashima, Atsuto; Sato, Tsubasa; Kimura, Yuya; Matsui, Hiroki; Iwasaki, Eisuke; Fushimi, Kiyohide; Yasunaga, Hideo; Kanai, Takanori |
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| 組織名 | Division of Gastroenterology and Hepatology, Department of Internal Medicine,;School of Medicine, Keio University, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;CentraCare, Interventional Endoscopy Program, St. Cloud Hospital, St. Cloud, MN.;Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota,;Minneapolis, MN.;Department of Gastroenterology and Hepatology, National Hospital Organization;Tokyo Medical Center, Tokyo, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Institute of Science Tokyo Graduate;School, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41489428/ |
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