2019 Volume 39 Issue 5 Pages 821-828
Recombinant human soluble thrombomodulin (rhTM) was recently approved, and has been introduced for treatment of disseminated intravascular coagulation (DIC). The aim of this study was to assess the efficacy and safety of rhTM in patients with sepsis-induced DIC after abdominal emergency surgery. A retrospective cohort study of 147 patients with sepsis-induced DIC after abdominal emergency surgery was performed at our hospital between January 2009 and December 2014. Propensity score matching created 47 matched pairs between the rhTM group and the group without rhTM. The DIC, fibrin degradation product (FDP) and systemic inflammatory response (SIRS) scores on day 7 significantly improved in the rhTM group, but the DIC resolution rate and 28 days mortality showed no significant difference between two groups. We stratified patients into several strata according to disease severity, determined by the acute physiology and chronic health (APACHE) Ⅱ and sequential organ failure assessment (SOFA) scores, and rhTM administration was significantly associated with improvement of the 28 days mortality rate in the very high risk group with an APACHEⅡ score≧20 and SOFA score≧6; P＝0.01. In conclusion, this study demonstrated that rhTM administration was associated with an improved DIC score among patients with sepsis-induced DIC after abdominal emergency surgery, and reduced the 28 days mortality rate in the very high risk patients.
