Clinical Impact of Recombinant Soluble Thrombomodulin for Disseminated Intravascular Coagulation Associated with Severe Acute Cholangitis.
- Author:
Atsushi OKUDA
1
;
Takeshi OGURA
;
Miyuki IMANISHI
;
Akira MIYANO
;
Nobu NISHIOKA
;
Kazuhide HIGUCHI
Author Information
- Publication Type:Original Article
- Keywords: Recombinant soluble thrombomodulin; Disseminated intravascular coagulation; Acute cholangitis; Thrombosis
- MeSH: Cholangitis*; Dacarbazine; Disseminated Intravascular Coagulation*; Drainage; Humans; Mortality; Multivariate Analysis; Survival Rate; Thrombomodulin*; Thrombosis
- From:Gut and Liver 2018;12(4):471-477
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Recently, recombinant human soluble thrombomodulin (rTM) has been developed as a new drug for disseminated intravascular coagulation (DIC). This study aims to evaluate the clinical benefit of rTM in patients with sepsis-induced DIC caused by acute cholangitis who underwent biliary drainage. METHODS: Patients were divided into two groups: the rTM therapy group and the non-rTM therapy group. The primary outcome was the DIC resolution rate at 7 days, and the secondary outcome was 28-day mortality rate. RESULTS: Thirty-five patients were treated by rTM, and 36 patients were treated without rTM for DIC. The rate of resolution of DIC at day 7 was significantly higher in the rTM group than in the non-rTM group (82.9% vs 55.6%, p=0.0012). Compared with the non-rTM group, the 28-day survival rate of the r-TM group was significantly higher (rTM vs non-rTM, 91.4% vs 69.4%, p=0.014). According to multivariate analysis, non-rTM (hazard ratio [HR], 2.681) and CRP (HR, 2.370) were factors related to decreased survival. CONCLUSIONS: rTM treatment may have a positive impact on improving DIC and survival rates in patients with severe acute cholangitis.
