The usefulness of antithrombin activity monitoring during antithrombin supplementation in patients with sepsis-associated disseminated intravascular coagulation.
Thromb Res. 2015 Mar 10;
Authors: Iba T, Saitoh D, Gando S, Thachil J
INTRODUCTION: Recent studies have repeatedly reported the effectiveness of antithrombin (AT) supplementation for sepsis-associated disseminated intravascular coagulation (DIC). In this study, we intended to elucidate the usefulness of monitoring antithrombin activity during antithrombin supplementation.
METHODS: Data of 926 patients with sepsis-associated DIC who had been undergone AT substitution were retrospectively analyzed. All the patients had received 1500IU/day of AT concentrate for three consecutive days. The patients' demographic characteristics, including the age, body weight, baseline DIC score and baseline AT activity, and treatment-related markers such as the change in DIC score and the change in the AT activity with treatment were analyzed in relation to the 28-day mortality.
RESULTS: Logistic regression analysis revealed a significant association of the patients' age, baseline AT activity, Δ AT activity, baseline DIC score and Δ DIC score to the patients' outcomes. The cutoff values of the AT activities for death calculated by the ROC curve analysis were 41.3% for the baseline AT activity, 72.9% for the post-treatment AT activity and 37.0% for Δ AT activity. The area under the ROC curve (AUC) showed discriminative powers for the baseline AT activity, post-treatment AT activity and Δ AT activity of 0.58, 0.69 and 0.66, respectively.
CONCLUSIONS: Monitoring of the AT activity is useful to predict the patients' outcome. Furthermore, the measurement of baseline AT activity may help in determining the appropriate dose for AT supplementation.
PMID: 25784136 [PubMed - as supplied by publisher]