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Recombinant Human Soluble Thrombomodulin Contributes to a Reduction In-Hospital Mortality of Acute Cholangitis with Disseminated Intravascular Coagulation: A Propensity Score Analyses of a Japanese Nationwide Database
- Source :
- The Tohoku Journal of Experimental Medicine. 252:53-61
- Publication Year :
- 2020
- Publisher :
- Tohoku University Medical Press, 2020.
-
Abstract
- The anti-DIC biological agent, recombinant human soluble thrombomodulin (rhTM), is being used clinically for DIC treatment in Japan. Patients with acute cholangitis associated with DIC are severe and require improved treatment. In addition, although clinical efficacy of rhTM in patients with acute cholangitis and DIC is expected, its efficacy is controversial. Thus, it is useful to evaluate rhTM in patients with acute cholangitis with DIC. This study aimed to validate the hypothesis that rhTM use improves in-hospital mortality in patients with acute cholangitis with DIC. A propensity score-matching analysis using a nationwide administrative database, the Japanese Diagnosis Procedure Combination Inpatient Database from April 2012 to March 2018, was performed. This database includes administrative claims data for all inpatients discharged from more than 1,000 participating hospitals, covering 92% of all tertiary-care emergency hospitals in Japan. Eligible patients (n = 2,865) were categorized into the rhTM (n = 1,636) or control groups (n = 1,229). Propensity score-matching created a matched cohort of 910 pairs with and without rhTM. In-hospital mortality between the groups in the unmatched analysis showed no significant difference (rhTM vs. control; 10.8% vs. 12.2%; p = 0.227). However, in-hospital mortality between the groups in the propensity score-matched analysis showed a significant difference (rhTM vs. control; 9.5% vs. 12.9%; p = 0.021). These results demonstrated that the rhTM group had significantly lower in-hospital mortality for patients with acute cholangitis with DIC. We propose that rhTM should be used for the treatment of patients with acute cholangitis with DIC.
- Subjects :
- Male
medicine.medical_specialty
Cholangitis
Thrombomodulin
General Biochemistry, Genetics and Molecular Biology
03 medical and health sciences
0302 clinical medicine
Matched cohort
Japan
hemic and lymphatic diseases
Internal medicine
medicine
Humans
Hospital Mortality
030212 general & internal medicine
Clinical efficacy
Propensity Score
Aged
Disseminated intravascular coagulation
In hospital mortality
business.industry
Significant difference
Nationwide database
General Medicine
Disseminated Intravascular Coagulation
medicine.disease
Soluble thrombomodulin
Recombinant Proteins
Logistic Models
Treatment Outcome
Databases as Topic
030220 oncology & carcinogenesis
Propensity score matching
Female
business
Subjects
Details
- ISSN :
- 13493329 and 00408727
- Volume :
- 252
- Database :
- OpenAIRE
- Journal :
- The Tohoku Journal of Experimental Medicine
- Accession number :
- edsair.doi.dedup.....10a1733ea815459492c5733d5408e668
- Full Text :
- https://doi.org/10.1620/tjem.252.53