Effect of antithrombin III among patients with disseminated intravascular coagulation in obstetrics: a nationwide observational study in Japan.
Antithrombin III
disseminated intravascular coagulation
obstetrics
propensity score matching
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
revised:
11
08
2021
received:
05
02
2021
accepted:
12
09
2021
pubmed:
22
9
2021
medline:
5
4
2022
entrez:
21
9
2021
Statut:
ppublish
Résumé
Pregnant women may develop disseminated intravascular coagulation (DIC), possibly resulting in massive maternal haemorrhage and perinatal death. The Japan guideline recommends use of antithrombin III (ATIII) for DIC in obstetrics; however, its effect remains uncertain. The present study aimed to investigate the effect of ATIII for DIC in obstetrics, using a national inpatient database in Japan. Nationwide observational study. Japan. We used the Diagnosis Procedure Combination inpatient database to identify patients who delivered at hospital and were diagnosed with DIC from July 2010 to March 2018. Propensity score matching analyses were performed to compare in-hospital maternal mortality and hysterectomy during hospitalisation between users and non-users of ATIII on the day of delivery. In-hospital mortality, hysterectomy. A total of 9920 patients were enrolled, including 4329 patients (44%) who used ATIII and 5511 patients (56%) who did not use ATIII. One-to-one propensity score matching created 3290 pairs. In-hospital maternal mortality did not differ significantly between the propensity-matched groups (0.3% in the ATIII group versus 0.5% in the control group; odds ratio 0.73; 95% CI 0.35-1.54). A significantly lower proportion of patients in the ATIII group, compared with those in the control group, underwent hysterectomy during hospitalisation (5.3% versus 8.7%; absolute risk difference -2.9%; 95% CI -4.2 to -1.6%). Although the present study did not show a mortality-reducing effect of ATIII for patients with DIC in obstetrics, it may have clinical benefit in terms of reducing the number of patients undergoing hysterectomy. This study did not show mortality-reducing effect of antithrombin III for patients with DIC in obstetrics.
Identifiants
pubmed: 34545675
doi: 10.1111/1471-0528.16938
doi:
Substances chimiques
Antithrombin III
9000-94-6
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
805-811Subventions
Organisme : Ministry of Education, Culture, Sports, Science and Technology, Japan
ID : 20H03907
Organisme : Ministry of Health, Labour and Welfare
ID : 19AA2007
Organisme : Ministry of Health, Labour and Welfare
ID : 20AA2005
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Singh B, Hanson AC, Alhurani R, Wang S, Herasevich V, Cartin-Ceba R, et al. Trends in the incidence and outcomes of disseminated intravascular coagulation in critically ill patients (2004-2010): a population-based study. Chest 2013;143:1235-42. https://doi.org/10.1378/chest.12-2112
Erez O, Mastrolia SA, Thachil J. Disseminated intravascular coagulation in pregnancy: insights in pathophysiology, diagnosis and management. Am J Obstet Gynecol 2015;213:452-63. https://doi.org/10.1016/j.ajog.2015.03.054
Rattray DD, O’Connell CM, Baskett TF. Acute disseminated intravascular coagulation in obstetrics: a tertiary centre population review (1980 to 2009). J Obstet Gynaecol Canada 2012;34:341-7. https://doi.org/10.1016/S1701-2163(16)35214-8
Wada H, Matsumoto T, Yamashita Y. Diagnosis and treatment of disseminated intravascular coagulation (DIC) according to four DIC guidelines. J Intensive Care 2014;2:15. https://doi.org/10.1186/2052-0492-2-15
Minakami H, Maeda T, Fujii T, Hamada H, Iitsuka Y, Itakura A, et al. Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2014 edition. J Obstet Gynaecol Res. 2014;40:1469-99. https://doi.org/10.1111/jog.12419
Tagami T, Matsui H, Fushimi K, Yasunaga H. Supplemental dose of antithrombin use in disseminated intravascular coagulation patients after abdominal sepsis. Thromb Haemost 2015;114:537-45.
Kawaguchi R, Matsumoto K, Akira S, Ishitani K, Iwasaku K, Ueda Y, et al. Guidelines for office gynecology in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2017 edition. J Obstet Gynaecol Res 2019;45:766-86. https://doi.org/10.1111/jog.13831
Maki M, Terao T, Ikenoue T, Takemura T, Sekiba K, Shirakawa K, et al. Clinical evaluation of antithrombin III concentrate (BI 6.013) for disseminated intravascular coagulation in obstetrics. Well-controlled multicenter trial. Gynecol Obstet Invest 1987;23:230-40. https://doi.org/10.1159/000298866
Maki M, Kobayashi T, Terao T, Ikenoue T, Satoh K, Nakabayashi M, et al. Antithrombin therapy for severe preeclampsia: results of a double-blind, randomized, placebo-controlled trial. BI51.017 Study Group. Thromb Haemost 2000;84(4):583-90.
Sameshima H, Kodama Y, Ikenoue T, Kajiwara Y. Antithrombin improves fetal condition in women with severe pre-eclampsia before 32 weeks of gestation; a randomized, double-blind, placebo-controlled trial. J Obstet Gynaecol Res 2008;34:34-9. https://doi.org/10.1111/j.1447-0756.2007.00677.x
Allingstrup M, Wetterslev J, Ravn FB, Møller AM, Afshari A. Antithrombin III for critically ill patients. Cochrane Database Syst Rev 2016;2:CD005370. https://doi.org/10.1002/14651858.CD005370.pub3
Rabinovich A, Abdul-Kadir R, Thachil J, Iba T, Othman M, Erez O. DIC in obstetrics: Diagnostic score, highlights in management, and international registry-communication from the DIC and Women's Health SSCs of the International Society of Thrombosis and Haemostasis. J Thromb Haemost 2019;17:1562-6. https://doi.org/10.1111/jth.14523
Benchimol EI, Smeeth L, Guttmann A, Harron K, Moher D, Petersen I, et al. The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. PLoS Med 2015;12(10):e1001885. https://doi.org/10.1371/journal.pmed.1001885
Shigemi D, Aso S, Yasunaga H. Inappropriate use of ritodrine hydrochloride for threatened preterm birth in Japan: a retrospective cohort study using a national inpatient database. BMC Pregnancy Childbirth 2019;19:204. https://doi.org/10.1186/s12884-019-2352-1
Shigemi D, Ishimaru M, Matsui H, Fushimi K, Yasunaga H. Suicide attempts among pregnant and postpartum women in Japan: a nationwide retrospective cohort study. J Clin Psychiatry 2020;81:19m12993. https://doi.org/10.4088/JCP.19m12993
Yasunaga H. Real world data in Japan: Chapter II the diagnosis procedure combination database. Ann Clin Epidemiol 2019;1:76-9. https://doi.org/10.37737/ace.1.3_76
Yamana H, Horiguchi H, Fushimi K, Yasunaga H. Comparison of procedure-based and diagnosis-based identifications of severe sepsis and disseminated intravascular coagulation in administrative data. J Epidemiol 2016;26:530-7. https://doi.org/10.2188/jea.JE20150286
Shigematsu K, Nakano H, Watanabe Y. The eye response test alone is sufficient to predict stroke outcome-reintroduction of Japan Coma Scale: a cohort study. BMJ Open 2013;3:e002736. https://doi.org/10.1136/bmjopen-2013-002736
Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012;379:2162-72. https://doi.org/10.1016/S0140-6736(12)60820-4
Griswold ME, Localio AR, Mulrow C. Propensity score adjustment with multilevel data: setting your sites on decreasing selection bias. Ann Intern Med 2010;152:393-5. https://doi.org/10.7326/0003-4819-152-6-201003160-00010
Rosenbaum PR, Rubin DB. Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Stat 1985;39:33-8.
Austin PC. Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. Stat Med 2009;28:3083-107. https://doi.org/10.1002/sim.3697
Leuven E & Sianesi B psmatch2 [https://www.ifs.org.uk/publications/2684]. Accessed 8 August 2020.
Miglioretti DL, Heagerty PJ. Marginal modeling of nonnested multilevel data using standard software. Am J Epidemiol 2007;165(4):453-63. https://doi.org/10.1093/aje/kwk020
Cole SR, Hernán MA. Constructing inverse probability weights for marginal structural models. Am J Epidemiol 2008;168:656-64. https://doi.org/10.1093/aje/kwn164
Baiocchi M, Cheng J, Small DS. Instrumental variable methods for causal inference. Stat Med 2014;33:2297-340. https://doi.org/10.1002/sim.6128
Garabedian LF, Chu P, Toh S, Zaslavsky AM, Soumerai SB. Potential bias of instrumental variable analyses for observational comparative effectiveness research. Ann Intern Med 2014;161:131-8. https://doi.org/10.7326/M13-1887
Terza JV, Basu A, Rathouz PJ. Two-stage residual inclusion estimation: addressing endogeneity in health econometric modeling. J Health Econ 2008;27:531-43. https://doi.org/10.1016/j.jhealeco.2007.09.009
Mammen EF. Antithrombin: its physiological importance and role in DIC. Semin Thromb Hemost 1998;24:19-25. https://doi.org/10.1055/s-2007-995819
Kobayashi T, Terao T, Maki M, Ikenoue T. Diagnosis and management of acute obstetrical DIC. Semin Thromb Hemost 2001;27:161-7. https://doi.org/10.1055/s-2001-14076
Fourrier F, Jourdain M, Tournoys A, Gosset P, Mangalaboyi J, Chopin C. Effects of a combined antithrombin III and protein C supplementation in porcine acute endotoxic shock. Shock 1998;10:364-70. https://doi.org/10.1097/00024382-199811000-00010
Gray E, Thomas S, Mistry Y, Poole S. Inhibition of tissue factor and cytokine release. Haemostasis 1996;26:92-5. https://doi.org/10.1159/000217247