Key result
Administration of recombinant human soluble thrombomodulin was associated with early improvement in the SOFA score within 48 hours.
Why the study?
It is unclear whether initial infection control or anticoagulant therapy exerts a greater effect on early changes in the SOFA score among patients with sepsis-induced DIC.
Does administration of recombinant human soluble thrombomodulin or adequate infection control improve early SOFA scores in patients with sepsis-induced DIC?
Cohort (n=52)
Does administration of recombinant human soluble thrombomodulin or adequate infection control improve early SOFA scores in patients with sepsis-induced DIC?
In patients with sepsis-induced DIC, recombinant human soluble thrombomodulin administration is strongly associated with early SOFA score improvement, whereas adequate infection control is critical for 28-day survival.
Answers are grounded in this paper and cite their sources.
May support rhTM consideration for early SOFA gains in sepsis-induced DIC; leaves open survival effects and requires RCT confirmation.
It is unclear whether initial infection control or anticoagulant therapy exerts a greater effect on early changes in the Sequential Organ Failure Assessment (SOFA) score among patients with sepsis-induced disseminated intravascular coagulation (DIC). This retrospective propensity score cohort study aimed to evaluate whether adequacy of infection control or anticoagulation therapy had a greater effect on early changes in the SOFA scores among 52 patients with sepsis-induced DIC. Inadequate initial infection control was associated with a lower 28-day survival rate among patients with sepsis-induced DIC (odds ratio [OR]: 0.116, 95% confidence interval [CI]: 0.022-0.601; P = .010); however, the adequacy was not associated with an early improvement in the SOFA score. However, despite adjusting for inadequate initial infection control, administration of recombinant human soluble thrombomodulin was associated with an early improvement in the SOFA score (OR: 5.058, 95% CI: 1.047-24.450; P = .044). Therefore, early changes in the SOFA score within 48 hours after the DIC diagnosis were more strongly affected by the administration of recombinant human soluble thrombomodulin than the adequacy of initial infection control.
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Mochizuki et al. (2018) conducted a cohort in sepsis-induced disseminated intravascular coagulation (DIC) (n=52). Recombinant human soluble thrombomodulin vs. No administration was evaluated on Early improvement in the SOFA score (OR 5.058, 95% CI 1.047-24.450, p=0.044). Administration of recombinant human soluble thrombomodulin was associated with early improvement in the SOFA score within 48 hours.
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