Abstract Number: PB0089
Meeting: ISTH 2021 Congress
Background: Antithrombin is a major anticoagulant controlling inflammation as well as coagulation. Low antithrombin level has been considered one of causes of organ dysfunction and poor outcome in disseminated intravascular coagulation (DIC).
Aims: We retrospectively analyzed serial changes in the levels of antithrombin to clarify its roles in trauma patients associated with DIC.
Methods: The 259 trauma patients were included and subdivided into 153 DIC and 106 non-DIC patients. Serial changes in platelet counts and coagulofibrinolytic parameters as well as antithrombin levels were evaluated from immediately after arrival at the emergency department (day 0), day 1 and days 2 to 6 (Late stage). During late stage, lowest antithrombin levels were used for analysis. Organ dysfunction was evaluated by Sequential Organ Failure Assessment (SOFA) socre and SOFA>12 was defined as multiple organ dysfunction syndome (MODS). Outcome measure was all-cause hospital mortality.
Results: DIC patients showed peresistently lower antithrombin levels at day 0 (63.8%), day 1(60.4%), and Late stage (60.9%) thant non-DIC patients (79.0, 77.0, 74.5%) (p<0.001) and was associated significantly higher rates of MODS (24.8 vs. 18,9%) and hospital mortarity (28.1 vs. 7.5%) than non-DIC patients. In addition, antithrombin levels at day 0 in died DIC patients (56.8%) were lower than that of survivors (66.5%) (p<0.001). Antithrombin levels at day 0 were independent predictor of death (Odds, 0.97; 95% CI 0.95-0.98, p<0.001).
Conclusions: DIC, especially died DIC patients, showed persistently low antithrombin levels immediate to late stage of trauma. Low antithrombin levels may have role in poor prognosis of trauma patients.
To cite this abstract in AMA style:Gando S, Wada T. Persistently Low Levels of Antithrombin in Trauma Patients Associated with Disseminated Intravascular Coagulation [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/persistently-low-levels-of-antithrombin-in-trauma-patients-associated-with-disseminated-intravascular-coagulation/. Accessed October 1, 2023.
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