Age-related differences in the survival benefit of the administration of antithrombin, recombinant human thrombomodulin, or their combination in sepsis

• Published in: Scientific reports Vol. 12; no. 1; pp. 9304 - 10
• Main Authors: Wada, Takeshi, Yamakawa, Kazuma, Kabata, Daijiro, Abe, Toshikazu, Ogura, Hiroshi, Shiraishi, Atsushi, Saitoh, Daizoh, Kushimoto, Shigeki, Fujishima, Seitaro, Mayumi, Toshihiko, Hifumi, Toru, Shiino, Yasukazu, Nakada, Taka-aki, Tarui, Takehiko, Otomo, Yasuhiro, Okamoto, Kohji, Umemura, Yutaka, Kotani, Joji, Sakamoto, Yuichiro, Sasaki, Junichi, Shiraishi, Shin-ichiro, Takuma, Kiyotsugu, Tsuruta, Ryosuke, Hagiwara, Akiyoshi, Masuno, Tomohiko, Takeyama, Naoshi, Yamashita, Norio, Ikeda, Hiroto, Ueyama, Masashi, Fujimi, Satoshi, Gando, Satoshi
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 03.06.2022; Nature Publishing Group; Nature Portfolio
• Subjects: 631/250/2500; 692/699/255/1318; Adult; Age; Anticoagulants; Anticoagulants - therapeutic use; Antithrombin; Antithrombin III; Antithrombins - therapeutic use; Disseminated intravascular coagulation; Disseminated Intravascular Coagulation - diagnosis; Disseminated Intravascular Coagulation - drug therapy; Humanities and Social Sciences; Humans; Mortality; multidisciplinary; Patients; Prospective Studies; Retrospective Studies; Science; Science (multidisciplinary); Secondary analysis; Sepsis; Survival; Thrombomodulin; Thrombomodulin - therapeutic use; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-13346-3

Disseminated intravascular coagulation (DIC) is one of the major organ dysfunctions associated with sepsis. This retrospective secondary analysis comprised data from a prospective multicenter study to investigate the age-related differences in the survival benefit of anticoagulant therapy in sepsis according to the DIC diagnostic criteria. Adult patients with severe sepsis based on the Sepsis-2 criteria were enrolled and divided into the following groups: (1) anticoagulant group (patients who received anticoagulant therapy) and (2) non-anticoagulant group (patients who did not receive anticoagulant therapy). Patients in the former group were administered antithrombin, recombinant human thrombomodulin, or their combination. The increases in the risk of hospital mortality were suppressed in the high-DIC-score patients aged 60–70 years receiving anticoagulant therapy. No favorable association of anti-coagulant therapy with hospital mortality was observed in patients aged 50 years and 80 years. Furthermore, anticoagulant therapy in the lower-DIC-score range increased the risk of hospital mortality in patients aged 50–60 years. In conclusion, anticoagulant therapy was associated with decreased hospital mortality according to a higher DIC score in septic patients aged 60–70 years. Anticoagulant therapy, however, was not associated with a better outcome in relatively younger and older patients with sepsis.