| アブストラクト | INTRODUCTION: Mortality and changes in treatment options for disseminated intravascular coagulation (DIC) are trending downward. This study investigated temporal trends in mortality and treatment preferences of several anticoagulants in Japan. METHODS: This retrospective observational study used the Japanese Diagnosis Procedure Combination inpatient database containing data from >1500 acute-care Japanese hospitals. All adult patients diagnosed as having DIC from July 2010 to March 2022 were sorted by predefined underlying conditions: sepsis, solid cancer, leukemia, trauma, or obstetric. We evaluated in-hospital mortality and clinical status of anticoagulant use for DIC treatment. RESULTS: Baseline characteristics of the 443,098 DIC patients showed increased age, worsened comorbid conditions, and higher illness severity over time. Over the 12 years, in-hospital mortality for overall DIC patients declined by 17 % from 42.0 % (95 % CI 41.4-42.5 %) to 34.7 % (95 % CI 34.1-35.3 %) (P(trend) < 0.001). This downward decrease was more evident in patients with sepsis (17 %), solid cancer (18 %), and leukemia (22 %) but was not clinically meaningful in trauma and obstetrics patients. The trend in treatment preferences of anticoagulants for DIC patients also changed. Recombinant thrombomodulin administration increased dramatically from 2011 to 2015 and remained high through 2021. Only 7 % of DIC patients were administered antithrombin and recombinant thrombomodulin concomitantly, and its use continues to decline. CONCLUSIONS: All-cause in-hospital mortality for DIC patients clearly decrease by 17 % over the study period. Anticoagulant therapy for patients with DIC has been decreasing, possibly due to recent published clinical evidence. |
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| ジャーナル名 | Thrombosis research |
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| Pubmed追加日 | 2024/11/13 |
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| 投稿者 | Yamakawa, Kazuma; Ohbe, Hiroyuki; Mochizuki, Katsunori; Hisamune, Ryo; Ushio, Noritaka; Kushimoto, Shigeki; Fushimi, Kiyohide; Yasunaga, Hideo |
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| 組織名 | Department of Emergency and Critical Care Medicine, Osaka Medical and;Pharmaceutical University, Takatsuki, Osaka, Japan. Electronic address:;kazuma.yamakawa@ompu.ac.jp.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan; Division of Emergency and Critical;Care Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.;Pharmaceutical University, Takatsuki, Osaka, Japan.;Division of Emergency and Critical Care Medicine, Tohoku University Graduate;School of Medicine, Sendai, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, Tokyo, Japan.;Health, The University of Tokyo, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39515187/ |
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