KMID : 0869620190360020232
|
|
Journal of Korean Society of Hospital Pharmacists 2019 Volume.36 No. 2 p.232 ~ p.243
|
|
Analysis of Clinical Effects of Antithrombin¥² Supplementation Therapy in Patients with Sepsis-induced Disseminated Intravascular Coagulation
|
|
Park Ju-Yeon
Jung Sun-Mi Oh Myung-Hyun Kim Jae-Song Son Eun-Sun
|
|
Abstract
|
|
|
Background : A recent research study published in Japan showed the clinical effects of AT¥² supplementation therapy in patients with sepsis-induced disseminated intravascular coagulation (DIC). The study found that in-hospital mortality decreased only in the group with AT¥² activation of 43% or less (HR: 0.603, P=0.045). Based on that study, it would be needed to verify a domestic application standard, starting a supplementation therapy at 70% or less of AT¥² activity. Hence, this study conducted a retrospective analysis of clinical effects according to AT¥² activation and suggested the need for a new application standard.
Methods : Data collected from the electronic medical record were divided into two groups based on 43% AT¥² activation and the data were analyzed for differences in prothrombin time (PT) and platelet improvement, PT and platelet variation, and 28-day mortality.
Results : In 76 sepsis-induced DIC patients who were injected with AT¥² from January 2015 to December 2017, 35 patients (46.05%) had an AT¥² activation of 43% or less and 41 (53.95%) were over 43 percent. The number of patients who had PT improvement after AT¥² supplementation therapy was 16 (45.7%) in the 43% or less ATIII group and 12 (29.3%) in the >43% group (P=0.138). Three patients (8.6%) had platelet improvement in the 43% or less group and three (7.3%) had platelet improvement in the >43% ATIII group (P=1.000). The PT variation was -4.94¡¾7.65 and -3.38¡¾4.89 in the 43% or less and >43% ATIII groups, respectively (P=0.286). The platelet variation was 11.47¡¾30.7 and 6.31¡¾31.86 in the 43% or less and >43% ATIII groups, respectively (P=0.478). The 28-day mortality was 48.6% in the 43% or less ATIII group and 41.5% in the >43% group (P=0.534).
Conclusions : As a result of comparing patients exceeding 43% AT¥² activation with those below 43%, the frequency of PT improvement and the mean of PT variation showed that the patients with 43% AT¥² activation or less had a tendency toward improvement on a numerical basis. Accordingly, large-scale, multi-center studies are needed to generate a new domestic application standard for AT¥² supplementation therapy.
|
|
KEYWORD
|
|
Antithrombin¥², DIC, AT¥² activation, Sepsis, Septic shock
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|