Chung Jae Sik, Kim Myoung Jun, Choi Young Un, Kim Jun Gi, Bae Keum Seok
Department of Surgery, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju 26426, Republic of Korea.
Healthcare (Basel). 2023 May 18;11(10):1476. doi: 10.3390/healthcare11101476.
We aimed to investigate the effects of antithrombin III administration on the prognosis of severe trauma patients with disseminated intravascular coagulation (DIC).
Medical records of a total of 4023 patients who were admitted to the intensive care unit (ICU) at the single regional trauma center from January 2016 to December 2020 were retrospectively analyzed. After the exclusion of young patients (<15 years old), mild trauma (ISS < 16), non DIC, etc., a total of 140 patients were included in the study. These patients were classified into antithrombin III-administered and non-antithrombin III-administered groups. Clinical data, including laboratory findings, trauma- and ICU-related severity scores, prognosis (including length of hospital stay), and need for organ support, were retrospectively collected. We evaluated the characteristics of the two groups, and compared and analyzed the vital signs, laboratory findings, prognosis, and clinical outcomes of each group. With this, we analyzed the effect of antithrombin III administration in severe trauma patients with DIC.
Of the 140 patients, 61 were treated with antithrombin III. No significant difference was observed in the baseline characteristics between the two groups for initial laboratory results, initial vital signs, or trauma-related severity scores. The improvement of the sequential organ failure assessment (SOFA) score, a prognostic marker, was significantly greater in the administered group ( = 0.009). Additionally, the antithrombin-administered group showed a larger improvement in the SOFA score than the non-administered group ( = 0.002). However, there was no statistical difference between the two groups for the frequency or duration of organ support treatments (renal replacement therapy, mechanical ventilation), mortality, or length of hospital stay.
Antithrombin III administration in severe trauma patients with DIC improved SOFA scores and aided in multi-organ dysfunction recovery. Appropriate indications should be studied to maximize the drug's improvement effect in patients with severe trauma in the future.
我们旨在研究给予抗凝血酶III对重度创伤并发弥散性血管内凝血（DIC）患者预后的影响。
回顾性分析了2016年1月至2020年12月期间在单一地区创伤中心重症监护病房（ICU）收治的4023例患者的病历。排除年轻患者（<15岁）、轻度创伤（损伤严重度评分<16）、非DIC等情况后，共有140例患者纳入研究。这些患者被分为抗凝血酶III给药组和非抗凝血酶III给药组。回顾性收集临床数据，包括实验室检查结果、创伤和ICU相关严重程度评分、预后（包括住院时间）以及器官支持需求。我们评估了两组的特征，并比较和分析了每组的生命体征、实验室检查结果、预后和临床结局。据此，我们分析了给予抗凝血酶III对重度创伤并发DIC患者的影响。
140例患者中，61例接受了抗凝血酶III治疗。两组在初始实验室检查结果、初始生命体征或创伤相关严重程度评分的基线特征方面未观察到显著差异。作为预后指标的序贯器官衰竭评估（SOFA）评分在给药组的改善更为显著（P = 0.009）。此外，抗凝血酶给药组的SOFA评分改善幅度大于未给药组（P = 0.002）。然而，两组在器官支持治疗（肾脏替代治疗、机械通气）的频率或持续时间、死亡率或住院时间方面没有统计学差异。
对重度创伤并发DIC患者给予抗凝血酶III可改善SOFA评分，并有助于多器官功能障碍的恢复。未来应研究合适的适应证，以最大限度地发挥该药物对重度创伤患者的改善作用。
