Evidence map›Paper›PMID 29596106›Full record

Observational studyShock (Augusta, Ga.)2019

Recombinant Human-Soluble Thrombomodulin Contributes to Reduced Mortality in Sepsis Patients With Severe Respiratory Failure: A Retrospective Observational Study Using a Multicenter Dataset.

Shodai Yoshihiro, Masaaki Sakuraya, Mineji Hayakawa, Kota Ono, Akira Hirata, Akihiro Takaba, Natsuki Kawamura, Toru Tsutsui, Kenichi Yoshida, Yoshihiro Hashimoto

Open access · hybridAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Shock (Augusta, Ga.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 27 citations in OpenAlex.

  1. Review
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  3. Review
  4. Article
  5. Emerging therapeutic targets for sepsis.Expert opinion on therapeutic targets · 2021
    Review
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Shodai YoshihiroPharmaceutical Department, JA Hiroshima General Hospital at Jigozen, Hatsukaiti-shi, Hiroshima, Japan.
Masaaki SakurayaDivision of Emergency and Critical Care Medicine, JA Hiroshima General Hospital at Jigozen, Hatsukaiti-shi, Hiroshima, Japan.
Mineji HayakawaEmergency and Critical Care Center, Hokkaido University Hospital at Kita-ku, Sapporo-shi, Hokkaido, Japan.
Kota OnoClinical Research and Medical Innovation Center, Hokkaido University Hospital at Kita-ku, Sapporo-shi, Hokkaido, Japan.
Akira HirataPediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital at Chuo-ku, Kobe-shi, Hyogo, Japan.
Akihiro TakabaDivision of Emergency and Critical Care Medicine, JA Hiroshima General Hospital at Jigozen, Hatsukaiti-shi, Hiroshima, Japan.
Natsuki KawamuraDivision of Emergency and Critical Care Medicine, JA Hiroshima General Hospital at Jigozen, Hatsukaiti-shi, Hiroshima, Japan.
Toru TsutsuiDivision of Emergency and Critical Care Medicine, JA Hiroshima General Hospital at Jigozen, Hatsukaiti-shi, Hiroshima, Japan.
Kenichi YoshidaDivision of Emergency and Critical Care Medicine, JA Hiroshima General Hospital at Jigozen, Hatsukaiti-shi, Hiroshima, Japan.
Yoshihiro HashimotoPharmaceutical Department, JA Hiroshima General Hospital at Jigozen, Hatsukaiti-shi, Hiroshima, Japan.
Hiroshima General Hospital · JPHokkaido University Hospital · JPKobe Children's Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecombinant human-soluble thrombomodulin (rhTM) is a novel class therapeutic agent for managing disseminated intravascular coagulation. The progression of severe respiratory failure may be related to intra-alveolar coagulation/fibrinolytic disorders. We aimed to determine the efficacy of rhTM in treating sepsis patients with severe respiratory failure.

methodsWe performed a retrospective observational study using an existing dataset collected from 42 intensive care units (ICUs) in Japan. Of 3,195 patients with severe sepsis or septic shock from the dataset, we selected sepsis patients with severe respiratory failure, and compared patient outcomes based on the administration of rhTM (rhTM group and no rhTM group). Propensity score analysis was performed between the two groups. Outcomes of interest were ICU mortality, hospital mortality, and ventilator-free days (VFDs).

resultsIn this study, 1,180 patients (rhTM, n = 356; no rhTM, n = 824) were analyzed. After adjusting for baseline imbalances with propensity score matching, the survival-time analysis revealed a significant difference between the two groups (hazard ratio, 0.654; 95% confidence interval, 0.439-0.974, P = 0.03). ICU mortality was lower in the rhTM group (rhTM: 22.1% [33/149] vs. no rhTM: 36.2% [54/149], P = 0.01). Hospital mortality was also lower in the rhTM group (35.6% [53/149] vs. 49.7% [74/149], P = 0.02). VFDs trended to be higher in the rhTM group than the no rhTM group (12.8 ± 10.1 days vs. 10.6 ± 10.6 days, P = 0.09).

conclusionsAdministration of rhTM was positively correlated with a reduction in mortality in sepsis patients with severe respiratory failure.

Indexed as

Hospital MortalityRespiratory InsufficiencyShock, SepticThrombomodulinAgedAged, 80 and overDisease-Free SurvivalFemaleHumansMaleMiddle AgedRecombinant ProteinsRetrospective StudiesSeverity of Illness IndexSurvival RateRecombinant ProteinsTHBD protein, humanThrombomodulin

Identifiers

PMID29596106
PMCPMC6319596
OpenAlexW2801189544

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.