Evidence map›Paper›PMID 38915122›Full record

ArticleJournal of intensive care2024

Determining prognostic indicator for anticoagulant therapy in sepsis-induced disseminated intravascular coagulation.

Toshiaki Iba, Kazuma Yamakawa, Yuki Shiko, Ryo Hisamune, Tomoki Tanigawa, Julie Helms, Jerrold H Levy

Abstract read
In one paragraph

Article in Journal of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
  2. Infection and drug resistance · 2026
    Review
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

7 authors.

Toshiaki IbaDepartment of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-Ku, Tokyo, 113-8421, Japan. toshiiba@juntendo.ac.jp.ORCID http://orcid.org/0000-0002-0255-4088
Kazuma YamakawaDepartment of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.ORCID http://orcid.org/0000-0003-2999-4021
Yuki ShikoDepartment of Biostatistics, Graduate School of Medicine, Research Administration Center, Saitama Medical University, Saitama, Japan.ORCID http://orcid.org/0000-0002-3959-9343
Ryo HisamuneDepartment of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.ORCID http://orcid.org/0009-0009-3339-1902
Tomoki TanigawaMedical Affairs Section, Research and Development Division, Japan Blood Products Organization, Tokyo, Japan.
Julie HelmsStrasbourg University (UNISTRA); Strasbourg University Hospital, Medical Intensive Care Unit, NHC; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.ORCID http://orcid.org/0000-0003-0895-6800
Jerrold H LevyDepartment of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, USA.ORCID http://orcid.org/0000-0003-3766-4962

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no reliable indicator that can assess the treatment effect of anticoagulant therapy for sepsis-associated disseminated intravascular coagulation (DIC) in the short term. The aim of this study is to develop and validate a prognostic index identifying 28-day mortality in septic DIC patients treated with antithrombin concentrate after a 3-day treatment.

methodsThe cohort for derivation was established utilizing the dataset from post-marketing surveys, while the cohort for validation was acquired from Japan's nationwide sepsis registry data. Through univariate and multivariate analyses, variables that were independently associated with 28-day mortality were identified within the derivation cohort. Risk variables were then assigned a weighted score based on the risk prediction function, leading to the development of a composite index. Subsequently, the area under the receiver operating characteristic curve (AUROC). 28-day survival was compared by Kaplan-Meier analysis.

resultsIn the derivation cohort, 252 (16.9%) of the 1492 patients deceased within 28 days. Multivariable analysis identified DIC resolution (hazard ratio [HR]: 0.31, 95% confidence interval [CI]: 0.22-0.45, P < 0.0001) and rate of Sequential Organ Failure Assessment (SOFA) score change (HR: 0.42, 95% CI: 0.36-0.50, P < 0.0001) were identified as independent predictors of death. The composite prognostic index (CPI) was constructed as DIC resolution (yes: 1, no: 0) + rate of SOFA score change (Day 0 SOFA score-Day 3 SOFA score/Day 0 SOFA score). When the CPI is higher than 0.19, the patients are judged to survive. Concerning the derivation cohort, AUROC for survival was 0.76. As for the validation cohort, AUROC was 0.71.

conclusionCPI can predict the 28-day survival of septic patients with DIC who have undergone antithrombin treatment. It is simple and easy to calculate and will be useful in practice.

Indexed as

AntithrombinDisseminated intravascular coagulationEndpointSepsisSequential Organ Failure Assessment score

Identifiers

PMID38915122
PMCPMC11194983

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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.