Disseminated intravascular coagulation (DIC) is a common and critical complication in sepsis. Antithrombin activity, which is considered a biomarker for disease severity, was measured in septic DIC treated with antithrombin concentrates in this study. We conducted a retrospective analysis of post-marketing survey data that included 1,800 patients with sepsis-associated DIC and antithrombin activity of 70% or less who were treated with antithrombin concentrates. The changes in sequential organ failure assessment (SOFA) score, DIC score, and antithrombin activity were sequentially assessed. Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to evaluate the performance of antithrombin activity to assess 28-day survival. Furthermore, the relationship between post-treatment antithrombin activity and survival was examined by Logistic regression analysis. Sex, baseline SOFA score, baseline antithrombin activities, and the presence of pneumonia and soft tissue infection were significantly associated with 28-day mortality. The area under the curve for mortality was 0.639 for post-treatment antithrombin activity, and higher than those of baseline- and delta antithrombin activities. Logistic regression analysis revealed that higher post-treatment antithrombin activity was associated with better 28-day survival. When post-treatment antithrombin activity was more than 80%, the estimated survival was 88.2%. Whereas, the survival was 74.4% when the antithrombin activity was 80% or less (P < 0.0001). However, the relationship between post-treatment antithrombin activity and 28-day survival was considerably different between patients who recovered from DIC by Day 6 compared to those who did not. Similarly, the estimated 28-day survival, based on antithrombin activity, varied among patients with high and low SOFA scores, and the calculation needs to be adjusted based on the severity of the condition. Post-treatment antithrombin activity measurement was helpful in estimating the 28-day survival in patients with sepsis-associated DIC. However, patient outcomes vary considerably depending on factors that include baseline SOFA score, age, and baseline antithrombin activity. These variables play a substantial role in determining patient prognosis and should be considered when evaluating and interpreting the results.

中文翻译：

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替代治疗后抗凝血酶活性的恢复与脓毒症相关弥散性血管内凝血患者 28 天死亡率的改善相关

弥散性血管内凝血（DIC）是脓毒症常见且严重的并发症。抗凝血酶活性被认为是疾病严重程度的生物标志物，在本研究中测量了用抗凝血酶浓缩物治疗的脓毒症 DIC。我们对上市后调查数据进行了回顾性分析，其中包括 1,800 名患有脓毒症相关 DIC 且抗凝血酶活性为 70% 或更低且接受抗凝血酶浓缩物治疗的患者。依次评估序贯器官衰竭评估（SOFA）评分、DIC评分和抗凝血酶活性的变化。进行逻辑回归分析和受试者工作特征（ROC）曲线分析来评估抗凝血酶活性的性能，从而评估 28 天生存率。此外，通过逻辑回归分析检查治疗后抗凝血酶活性与生存之间的关系。性别、基线 SOFA 评分、基线抗凝血酶活性以及肺炎和软组织感染的存在与 28 天死亡率显着相关。治疗后抗凝血酶活性的死亡率曲线下面积为 0.639，高于基线和 delta 抗凝血酶活性。Logistic 回归分析显示，较高的治疗后抗凝血酶活性与较好的 28 天生存率相关。当治疗后抗凝血酶活性超过80%时，估计生存率为88.2%。而当抗凝血酶活性为80%或更低时，存活率为74.4%（P < 0.0001）。然而，在第 6 天从 DIC 恢复的患者与未恢复的患者之间，治疗后抗凝血酶活性与 28 天生存率之间的关系存在显着差异。同样，根据抗凝血酶活性估计的 28 天生存率在 SOFA 评分高和低的患者之间存在差异，并且需要根据病情的严重程度调整计算。治疗后抗凝血酶活性测量有助于估计脓毒症相关 DIC 患者的 28 天生存率。然而，患者的结果差异很大，具体取决于基线 SOFA 评分、年龄和基线抗凝血酶活性等因素。这些变量在确定患者预后方面发挥着重要作用，在评估和解释结果时应予以考虑。