神戸大学附属図書館デジタルアーカイブ
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https://hdl.handle.net/20.500.14094/90005455
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2024-05-01
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90005455 (fulltext)
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メタデータID
90005455
アクセス権
open access
出版タイプ
Accepted Manuscript
タイトル
The anticoagulant treatment for sepsis induced disseminated intravascular coagulation; network meta-analysis
著者
Yatabe, Tomoaki ; Inoue, Shigeaki ; Sakamoto, So ; Sumi, Yuka ; Nishida, Osamu ; Hayashida, Kei ; Hara, Yoshitaka ; Fukuda, Tatsuma ; Matsushima, Asako ; Matsuda, Akihisa ; Yasuda, Hideto ; Yamashita, Kazuto ; Egi, Moritoki
著者名
Yatabe, Tomoaki
著者ID
A2411
研究者ID
1000030582209
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=34321d03fcf61f45520e17560c007669
著者名
Inoue, Shigeaki
井上, 茂亮
イノウエ, シゲアキ
所属機関名
医学研究科
著者名
Sakamoto, So
著者名
Sumi, Yuka
著者名
Nishida, Osamu
著者名
Hayashida, Kei
著者名
Hara, Yoshitaka
著者名
Fukuda, Tatsuma
著者名
Matsushima, Asako
著者名
Matsuda, Akihisa
著者名
Yasuda, Hideto
著者名
Yamashita, Kazuto
著者ID
A1648
研究者ID
1000020423296
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=15aa80040e563e89520e17560c007669
著者名
Egi, Moritoki
江木, 盛時
エギ, モリトキ
所属機関名
医学研究科
収録物名
Thrombosis Research
巻(号)
171
ページ
136-142
出版者
Elsevier
刊行日
2018-11
公開日
2019-12-01
抄録
Introduction: The benefits and harm caused by anticoagulant treatments for sepsis induced disseminated intravascular coagulation (DIC) remain unclear. Therefore, we performed a network meta-analysis to assess the effect of available anticoagulant treatments on patient mortality, DIC resolution and the incidence of bleeding complication in patients with septic DIC. Materials and methods: We considered all studies from four recent systematic reviews and searched the PubMed, MEDLINE, and Cochrane databases for other studies that investigated anticoagulant treatment for septic DIC using antithrombin, thrombomodulin, heparin, or protease inhibitors in adult critically ill patients. These four anticoagulants and placebo were compared. The primary outcome in this study was patient mortality, and the secondary outcomes were the DIC resolution rate and incidence of bleeding complications. Results: The network meta-analysis included 1340 patients from nine studies. There were no significant differences in the risks of mortality and bleeding complications among all direct comparisons and the network meta-analysis. Using a placebo was associated with a significantly lower rate of DIC resolution, compared to antithrombin in the direct comparison (odds ratio [OR]: 0.20, 95% credible interval [95% CrI]: 0.046-0.81) and in the network meta-analysis (OR: 0.20, 95% CrI: 0.043-0.84). Conclusions: Our study revealed no significant differences in the risks for mortality and bleeding complications when a placebo and all four anticoagulants were compared in septic DIC patients. The results also indicated that antithrombin was associated with a five-fold higher likelihood of DIC resolution, compared to placebo.
キーワード
Anticoagulant treatment
Disseminated intravascular coagulation
Sepsis
Network meta-analysis
カテゴリ
医学研究科
学術雑誌論文
権利
© 2018 Elsevier.
This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
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資源タイプ
journal article
言語
English (英語)
ISSN
0049-3848
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NCID
AA00863148
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関連情報
DOI
https://doi.org/10.1016/j.thromres.2018.10.007
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