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First day dynamic changes in antithrombin III activity after supplementation have a predictive value in critically
Satoshi Gando1, Atsushi Sawamura, Mineji Hayakawa
1Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan. gando@med.hokudai.ac.jp
American Journal of Hematology
|August 23, 2006
Summary
Assessing antithrombin III (antithrombin) levels after initial supplementation helps predict outcomes in critically ill patients. A first-day increase over 60% indicates better survival and improved coagulation markers.
Area of Science:
- Critical Care Medicine
- Hematology
- Pharmacology
Background:
- Critically ill patients often experience altered coagulation.
- Antithrombin III (antithrombin) supplementation is used to manage coagulopathy.
- Predicting patient outcomes is crucial for effective treatment strategies.
Purpose of the Study:
- To evaluate if changes in antithrombin III (antithrombin) levels after supplementation predict outcomes in critically ill patients.
- To identify predictors of mortality in patients receiving antithrombin therapy.
- To assess the impact of antithrombin supplementation on coagulation parameters.
Main Methods:
- Retrospective study of 435 critically ill patients treated with antithrombin.
- Patients were divided into responders (antithrombin activity >60% on Day 1) and non-responders.
- Logistic regression analysis was used to identify predictors of ICU mortality.
Main Results:
- Two hundred eighty-eight patients (66%) were responders.
- Responder group showed significantly better outcomes compared to non-responders.
- A Day 1 antithrombin increase <60% was independently associated with ICU mortality.
- Responders exhibited increased platelet counts, fibrinogen levels, and decreased DIC scores.
Conclusions:
- The dynamic change in antithrombin III (antithrombin) activity on the first day post-supplementation, not the baseline level, predicts mortality in critically ill patients.
- Achieving >60% antithrombin activity on Day 1 is linked to improved survival.
- This response correlates with improvements in platelet count, fibrinogen, and disseminated intravascular coagulation (DIC) scores.
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