scholarly journals Seasonal Variation and Severity of Acute Abdomen in Japan: A Nine-Year Retrospective Analysis

2021 ◽  
Vol 11 (12) ◽  
pp. 1346
Author(s):  
Hidero Yoshimoto ◽  
Kazuma Yamakawa ◽  
Yutaka Umemura ◽  
Kensuke Fujii ◽  
Eriko Nakamura ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Observational Study ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Disseminated Intravascular Coagulation ◽  
Seasonal Variations ◽  
Seasonal Incidence ◽  
Intravascular Coagulation ◽  
Failure Assessment ◽  
Acute Hospitals

The seasonal incidence of acute abdomens, such as appendicitis, is reportedly more common in summer but is reported less frequently in Asia. Additionally, seasonal variations in the severity of acute abdomens have been evaluated insufficiently. This study evaluated the seasonal variations in the incidence and severity of acute abdomens in Japan. This retrospective observational study used a multicenter database containing data from 42 acute hospitals in Japan. We included all patients diagnosed with acute appendicitis, diverticulitis, cholecystitis, and cholangitis between January 2011 and December 2019. Baseline patient data included admission date, sequential organ failure assessment score, presence of sepsis, and disseminated intravascular coagulation. We enrolled 24,708 patients with acute abdomen. Seasonal admissions for all four acute abdominal diseases were the highest in summer [acute appendicitis, (OR = 1.35; 95% CI = 1.28–1.43); diverticulitis, (OR = 1.23; 95% CI = 1.16–1.31; cholecystitis (OR = 1.23; 95% CI = 1.11–1.36); and cholangitis (OR = 1.23; 95% CI = 1.12–1.36)]. The proportion of patients with sepsis and disseminated intravascular coagulation as well as the total SOFA score for each disease, did not differ significantly across seasons. Seasonal variations in disease severity were not observed.

scholarly journals Impact of Antithrombin Supplementation and Concomitant Anticoagulation Therapy in Pediatric Patients With Disseminated Intravascular Coagulation

2019 ◽  
Vol 25 ◽  
pp. 107602961983435
Author(s):  
Hiroyuki Nagafuchi ◽  
Yutaka Eguchi ◽  
Toshiaki Ikeda
Keyword(s):  
Organ Failure ◽  
Disseminated Intravascular Coagulation ◽  
Pediatric Patients ◽  
Anticoagulation Therapy ◽  
Standardized Mortality Ratio ◽  
Efficacy And Safety ◽  
Resolution Rate ◽  
Intravascular Coagulation ◽  
Failure Assessment ◽  
Mortality Ratio

We aimed to evaluate the efficacy and safety of antithrombin (AT) supplementation and concomitant anticoagulation therapy in 65 children who met the Japanese Ministry of Health and Welfare (JMHW) disseminated intravascular coagulation (DIC) criteria and had received AT concentrate and/or other concomitant anticoagulants. The primary efficacy end point was to determine standardized mortality ratio (SMR). The secondary efficacy end points were DIC resolution rate and pediatric sequential organ failure assessment (pSOFA) score on day 3. The 28-day mortality rate was 6.8%; SMR was 0.55. Disseminated intravascular coagulation resolution rate on day 3 was 54.5%. The JMHW DIC scores at day 0 ( P = .005) and pSOFA scores at day 3 ( P = .018) were significantly lower in patients with resolution of DIC than in those without resolution of DIC. The target cutoff value for JMHW DIC score on day 0 was 6. No bleeding-related adverse events were associated with AT administration. In children with DIC, AT supplementation and concomitant anticoagulation therapy can be safely used as initial treatment when JMHW DIC score is 6; it may improve DIC resolution, organ failure, and mortality rates.

Clinical course and outcome of disseminated intravascular coagulation diagnosed by Japanese Association for Acute Medicine criteria

2008 ◽  
Vol 100 (12) ◽  
pp. 1099-1105 ◽  
Author(s):  
Satoshi Gando ◽  
Daizoh Saitoh ◽  
Hiroshi Ogura ◽  
Toshihiko Mayumi ◽  
Kazuhide Koseki ◽  
...  
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Clinical Course ◽  
Trauma Patients ◽  
Acute Medicine ◽  
Japanese Association ◽  
Intravascular Coagulation ◽  
Coagulation Abnormalities ◽  
Failure Assessment ◽  
Jaam Criteria ◽  
Prothrombin Time Ratio

SummaryThe Japanese Association for Acute Medicine (JAAM) disseminated intravascular coagulation (DIC) study group recently announced new diagnostic criteria for DIC. These criteria have been prospectively validated and demonstrated to progress to overt DIC as defined by the International Society on Thrombosis and Haemostasis (ISTH).Although an underlying condition is essential for the development of DIC, it has never been clarified if patients with different underlying disorders have a similar course. Among 329 patients with DIC diagnosed by the JAAM criteria, those with underlying sepsis (n=98) or trauma (n=95) were compared. The 28-day mortality rate was significantly higher in sepsis patients than trauma patients (34.7% vs. 10.5%, p<0.0001).Within three days of fulfilling the JAAM criteria, sepsis patients had a lower platelet count, higher prothrombin time ratio, higher systemic inflammatory response syndrome score, and higher Sequential Organ Failure Assessment score compared with trauma patients. On day 3, a significantly higher percentage of trauma patients than sepsis patients showed improvement of DIC (64.2% vs. 30.6%, p<0.001).These differences were mainly due to patients with lower JAAM DIC scores. More than 50% of the JAAM DIC patients with sepsis who died within 28 days could not be detected by ISTH DIC criteria during the initial three days. In contrast, most trauma patients who died within 28 days had DIC simultaneously diagnosed by JAAM and ISTH criteria, except for those with brain death. These findings suggest that coagulation abnormalities, organ dysfunction, and the outcome of JAAM DIC differ between patients with sepsis and trauma.

scholarly journals Associations Among Coagulation-Related Variables, Resolution of Disseminated Intravascular Coagulation (DIC), and Mortality in Patients with Sepsis-Induced DIC Treated with Recombinant Human Soluble Thrombomodulin: A Retrospective Observational Study

2021 ◽  
Author(s):  
Chieko Mitaka ◽  
Izumi Kawagoe ◽  
Daizoh Satoh ◽  
Masakazu Hayashida
Keyword(s):  
Platelet Count ◽  
Observational Study ◽  
Disseminated Intravascular Coagulation ◽  
Early Phase ◽  
Degradation Products ◽  
International Normalized Ratio ◽  
Soluble Thrombomodulin ◽  
Intravascular Coagulation ◽  
Before And After ◽  
Recombinant Human Soluble Thrombomodulin

Abstract Background: We evaluated associations among coagulation-related variables, resolution of disseminated intravascular coagulation (DIC), and mortality in patients with sepsis-induced DIC treated with recombinant human soluble thrombomodulin (rTM). Methods: We retrospectively investigated patients with sepsis-induced DIC treated with rTM. Changes in coagulation-related variables before and after treatment with rTM were examined. Further, associations between coagulation-related variables and DIC resolution were evaluated. Results: A total of 123 patients were included. The platelet count, prothrombin international normalized ratio (PT-INR), and fibrin/fibrinogen degradation products (FDP) significantly (p < 0.001) improved after rTM administration in survivors (n = 98), but not in nonsurvivors (n = 25). However, the DIC score significantly (p < 0.001) reduced not only in survivors but also in nonsurvivors. PT-INR before rTM was significantly (p = 0.0029) lower in patients attaining than not attaining DIC resolution (n = 87 and 36, respectively). The 28-day mortality was significantly lower in patients attaining than not attaining DIC resolution (11.5% vs. 41.7 %, p = 0.0001).Conclusions: The DIC score significantly reduced after rTM in both survivors and nonsurvivors. rTM might play an important role in improving DIC, especially when treatment with rTM is initiated in the early phase of DIC.

scholarly journals Usefulness of Measuring Changes in SOFA Score for the Prediction of 28-Day Mortality in Patients With Sepsis-Associated Disseminated Intravascular Coagulation

2019 ◽  
Vol 25 ◽  
pp. 107602961882404 ◽  
Author(s):  
Toshiaki Iba ◽  
Makoto Arakawa ◽  
Katsunori Mochizuki ◽  
Osamu Nishida ◽  
Hideo Wada ◽  
...  
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Sofa Score ◽  
Operating Characteristic ◽  
Japanese Society ◽  
Characteristic Curve ◽  
Curve Analysis ◽  
Acute Medicine ◽  
Intravascular Coagulation ◽  
Failure Assessment ◽  
Sepsis Trial

The primary end point for sepsis trial is 28-day mortality. However, additional methods for determining the efficacy may have benefits. The purpose of this study was to search a useful indicator of anticoagulant therapy in patients with sepsis with disseminated intravascular coagulation (DIC). Data from 323 patients with sepsis with coagulopathy treated with antithrombin supplementation were analyzed. The changes in the Sequential Organ Failure Assessment (Δ SOFA) score, the overt-DIC (Δ overt-DIC) score, and the Japanese Society for Acute Medicine DIC (Δ JAAM DIC) score from baseline to day 7 were retrospectively analyzed in relation to the 28-day mortality. Significant correlations were found between the 28-day mortality and Δ SOFA, Δ overt-DIC score, and Δ JAAM DIC score. The accuracy of the prediction was higher for Δ SOFA (80.5%) than for Δ overt-DIC (66.7%, P < .001). The areas under the curve for mortality calculated using a receiver operating characteristic curve analysis were 0.812 for Δ SOFA, 0.655 for Δ overt-DIC, and 0.693 for Δ JAAM DIC. The mortality rate was significantly lower among cases with an improved SOFA score compared to those without an improvement. The Δ SOFA had the strongest association with the 28-day mortality in patients with sepsis and DIC.

Observational study to compare antithrombin and thrombomodulin for disseminated intravascular coagulation

2014 ◽  
Vol 37 (1) ◽  
pp. 139-147 ◽  
Author(s):  
Atsuhiko Murata ◽  
Kohji Okamoto ◽  
Toshihiko Mayumi ◽  
Keiji Muramatsu ◽  
Shinya Matsuda
Keyword(s):  
Observational Study ◽  
Disseminated Intravascular Coagulation ◽  
Intravascular Coagulation
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