Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational Study
Supernormal antithrombin (AT) activity is rare in patients with sepsis. This study compared mortality rate of patients with sepsis and supernormal AT activity with that of other patients. This retrospective study included patients with sepsis from 42 intensive care units (ICUs) in Japan. Patients we...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2020-04-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/1076029620912827 |
| _version_ | 1818279296583598080 |
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| author | Takeo Azuhata MD, PhD Mineji Hayakwa MD, PhD Kunihiko Maekawa MD Tomohide Komatsu MD, PhD Tsukasa Kuwana MD, PhD Daisuke Kawano MD Kazuhiro Nakamura MD Kosaku Kinoshita MD, PhD Takeshi Wada MD, PhD Katsuhisa Tanjoh MD, PhD |
| author_facet | Takeo Azuhata MD, PhD Mineji Hayakwa MD, PhD Kunihiko Maekawa MD Tomohide Komatsu MD, PhD Tsukasa Kuwana MD, PhD Daisuke Kawano MD Kazuhiro Nakamura MD Kosaku Kinoshita MD, PhD Takeshi Wada MD, PhD Katsuhisa Tanjoh MD, PhD |
| author_sort | Takeo Azuhata MD, PhD |
| collection | DOAJ |
| description | Supernormal antithrombin (AT) activity is rare in patients with sepsis. This study compared mortality rate of patients with sepsis and supernormal AT activity with that of other patients. This retrospective study included patients with sepsis from 42 intensive care units (ICUs) in Japan. Patients were included if their AT activity was measured on ICU admission, and if they did not receive AT concentrate. They were categorized into low, normal, and supernormal with respective AT activity of ≤70%, >70% to ≤100%, and >100%. The primary outcome was hospital in-patient mortality. Nonlinear regression analysis showed that mortality risk gradually increased with AT activity in the supernormal range, but without statistical significance. Survival rate was significantly lower in low (67%) and supernormal (57%) AT groups than in the normal AT group (79%; P < .001 and P = .008, respectively). After adjusting for disease severity and AT activity on day 2, supernormal AT activity was the only independent predictor of mortality. Sepsis with supernormal AT activity associated with high mortality, independent of disease severity, might be a predictor of in-hospital mortality. |
| first_indexed | 2024-12-12T23:31:05Z |
| format | Article |
| id | doaj.art-c0a12631a9b34ce88bd97cf0fb34e6d3 |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-12-12T23:31:05Z |
| publishDate | 2020-04-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-c0a12631a9b34ce88bd97cf0fb34e6d32022-12-22T00:07:48ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232020-04-012610.1177/1076029620912827Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational StudyTakeo Azuhata MD, PhD0Mineji Hayakwa MD, PhD1Kunihiko Maekawa MD2Tomohide Komatsu MD, PhD3Tsukasa Kuwana MD, PhD4Daisuke Kawano MD5Kazuhiro Nakamura MD6Kosaku Kinoshita MD, PhD7Takeshi Wada MD, PhD8Katsuhisa Tanjoh MD, PhD9 Department of General and Acute Medicine, Seitokai Azuhata Hospital, Ibaraki, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Tokyo, Japan Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Tokyo, Japan Department of General and Acute Medicine, Seitokai Azuhata Hospital, Ibaraki, Japan Department of General and Acute Medicine, Seitokai Azuhata Hospital, Ibaraki, Japan Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Tokyo, Japan Department of Emergency Medicine, Hokkaido University Hospital, Sapporo, Japan Department of General and Acute Medicine, Seitokai Azuhata Hospital, Ibaraki, JapanSupernormal antithrombin (AT) activity is rare in patients with sepsis. This study compared mortality rate of patients with sepsis and supernormal AT activity with that of other patients. This retrospective study included patients with sepsis from 42 intensive care units (ICUs) in Japan. Patients were included if their AT activity was measured on ICU admission, and if they did not receive AT concentrate. They were categorized into low, normal, and supernormal with respective AT activity of ≤70%, >70% to ≤100%, and >100%. The primary outcome was hospital in-patient mortality. Nonlinear regression analysis showed that mortality risk gradually increased with AT activity in the supernormal range, but without statistical significance. Survival rate was significantly lower in low (67%) and supernormal (57%) AT groups than in the normal AT group (79%; P < .001 and P = .008, respectively). After adjusting for disease severity and AT activity on day 2, supernormal AT activity was the only independent predictor of mortality. Sepsis with supernormal AT activity associated with high mortality, independent of disease severity, might be a predictor of in-hospital mortality.https://doi.org/10.1177/1076029620912827 |
| spellingShingle | Takeo Azuhata MD, PhD Mineji Hayakwa MD, PhD Kunihiko Maekawa MD Tomohide Komatsu MD, PhD Tsukasa Kuwana MD, PhD Daisuke Kawano MD Kazuhiro Nakamura MD Kosaku Kinoshita MD, PhD Takeshi Wada MD, PhD Katsuhisa Tanjoh MD, PhD Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational Study Clinical and Applied Thrombosis/Hemostasis |
| title | Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational Study |
| title_full | Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational Study |
| title_fullStr | Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational Study |
| title_full_unstemmed | Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational Study |
| title_short | Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational Study |
| title_sort | supernormal antithrombin activity is an independent predictor of in hospital mortality in patients with sepsis a retrospective observational study |
| url | https://doi.org/10.1177/1076029620912827 |
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