PDF(Pubmed)
Abstract：
UNASSIGNED: Patients with trauma exhibit a complex balance of coagulopathy manifested by both bleeding and thrombosis. Antithrombin III is a plasma protein that functions as an important regulator of coagulation. Previous studies have found a high incidence of antithrombin III deficiency among patients with trauma.
UNASSIGNED: To assess whether changes in antithrombin III activity are associated with thrombohemorrhagic complications among patients with trauma.
UNASSIGNED: This cohort study was conducted from December 2, 2015, to March 24, 2017, at a level I trauma center. A total of 292 patients with trauma were followed up from their arrival through 6 days from admission. Data, including quantification of antithrombin III activity, were collected for these patients. Thromboprophylaxis strategy; hemorrhage, deep vein thrombosis (DVT), and pulmonary embolism screenings; and follow-up evaluations were conducted per institutional protocols. Data analyses were performed from September 28, 2023, to June 4, 2024.
UNASSIGNED: The primary study outcome measurements were associations between antithrombin III levels and outcomes among patients with trauma, including ventilator-free days, hospital-free days, intensive care unit (ICU)-free days, hemorrhage, venous thromboembolic events, and mortality.
UNASSIGNED: The 292 patients had a mean (SD) age of 54.4 (19.0) years and included 211 men (72.2%). Patients with an antithrombin III deficiency had fewer mean (SD) ventilator-free days (27.8 [5.1] vs 29.6 [1.4]; P = .0003), hospital-free days (20.3 [8.2] vs 24.0 [5.7]; P = 1.37 × 10-6), and ICU-free days (25.7 [4.9] vs 27.7 [2.3]; P = 9.38 × 10-6) compared with patients without a deficiency. Antithrombin III deficiency was also associated with greater rates of progressive intracranial hemorrhage (21.1% [28 of 133] vs 6.3% [10 of 159]; P = .0003) and thrombocytopenia (24.8% [33 of 133] vs 5.0% [8 of 159]; P = 1.94 × 10-6). Although antithrombin III deficiency was not significantly associated with DVT, patients who developed a DVT had a more precipitous decrease in antithrombin III levels that were significantly lower than patients who did not develop a DVT.
UNASSIGNED: In this cohort study of patients with trauma, antithrombin III deficiency was associated with greater injury severity, increased hemorrhage, and increased mortality, as well as fewer ventilator-free, hospital-free, and ICU-free days. Although this was an associative study, these data suggest that antithrombin III levels may be useful in the risk assessment of patients with trauma.
UNASSIGNED: To assess whether changes in antithrombin III activity are associated with thrombohemorrhagic complications among patients with trauma.
UNASSIGNED: This cohort study was conducted from December 2, 2015, to March 24, 2017, at a level I trauma center. A total of 292 patients with trauma were followed up from their arrival through 6 days from admission. Data, including quantification of antithrombin III activity, were collected for these patients. Thromboprophylaxis strategy; hemorrhage, deep vein thrombosis (DVT), and pulmonary embolism screenings; and follow-up evaluations were conducted per institutional protocols. Data analyses were performed from September 28, 2023, to June 4, 2024.
UNASSIGNED: The primary study outcome measurements were associations between antithrombin III levels and outcomes among patients with trauma, including ventilator-free days, hospital-free days, intensive care unit (ICU)-free days, hemorrhage, venous thromboembolic events, and mortality.
UNASSIGNED: The 292 patients had a mean (SD) age of 54.4 (19.0) years and included 211 men (72.2%). Patients with an antithrombin III deficiency had fewer mean (SD) ventilator-free days (27.8 [5.1] vs 29.6 [1.4]; P = .0003), hospital-free days (20.3 [8.2] vs 24.0 [5.7]; P = 1.37 × 10-6), and ICU-free days (25.7 [4.9] vs 27.7 [2.3]; P = 9.38 × 10-6) compared with patients without a deficiency. Antithrombin III deficiency was also associated with greater rates of progressive intracranial hemorrhage (21.1% [28 of 133] vs 6.3% [10 of 159]; P = .0003) and thrombocytopenia (24.8% [33 of 133] vs 5.0% [8 of 159]; P = 1.94 × 10-6). Although antithrombin III deficiency was not significantly associated with DVT, patients who developed a DVT had a more precipitous decrease in antithrombin III levels that were significantly lower than patients who did not develop a DVT.
UNASSIGNED: In this cohort study of patients with trauma, antithrombin III deficiency was associated with greater injury severity, increased hemorrhage, and increased mortality, as well as fewer ventilator-free, hospital-free, and ICU-free days. Although this was an associative study, these data suggest that antithrombin III levels may be useful in the risk assessment of patients with trauma.
摘要：
■创伤患者表现出复杂的凝血平衡，表现为出血和血栓形成。抗凝血酶III是一种血浆蛋白，可作为重要的凝血调节剂。先前的研究发现，创伤患者中抗凝血酶III缺乏症的发生率很高。
■评估创伤患者抗凝血酶III活性的变化是否与血栓出血性并发症相关。
■该队列研究于2015年12月2日至2017年3月24日在I级创伤中心进行。从到达医院到入院6天，共对292例创伤患者进行了随访。数据,包括抗凝血酶III活性的定量，为这些患者收集。血栓预防策略;出血,深静脉血栓形成(DVT),和肺栓塞筛查;并根据机构方案进行随访评估.数据分析从2023年9月28日至2024年6月4日进行。
■主要研究结果测量是抗凝血酶III水平与创伤患者结果之间的关联，包括无呼吸机日，没有医院的日子,重症监护病房（ICU）-免费天数，出血,静脉血栓栓塞事件,和死亡率。
■292名患者的平均年龄（SD）为54.4（19.0）岁，其中包括211名男性（72.2％）。抗凝血酶III缺乏症患者的平均（SD）无呼吸机天数较少（27.8[5.1]vs29.6[1.4]；P=.0003），无医院天数（20.3[8.2]vs24.0[5.7]；P=1.37×10-6），与无缺陷患者相比，无ICU天数（25.7[4.9]vs27.7[2.3]；P=9.38×10-6）。抗凝血酶III缺乏还与进行性颅内出血（21.1％[133中的28]比6.3％[159中的10]；P=.0003）和血小板减少症（24.8％[133中的33]比5.0％[159中的8]；P=1.94×10-6）的发生率更高。虽然抗凝血酶III缺乏与DVT没有显著关联,与未发生DVT的患者相比,发生DVT的患者的抗凝血酶III水平下降更为剧烈.
■在这项创伤患者的队列研究中，抗凝血酶III缺乏与更严重的损伤相关，出血增加，死亡率上升，以及更少的无呼吸机，无医院,无ICU日虽然这是一个联想研究,这些数据提示抗凝血酶III水平可能有助于创伤患者的风险评估.
■评估创伤患者抗凝血酶III活性的变化是否与血栓出血性并发症相关。
■该队列研究于2015年12月2日至2017年3月24日在I级创伤中心进行。从到达医院到入院6天，共对292例创伤患者进行了随访。数据,包括抗凝血酶III活性的定量，为这些患者收集。血栓预防策略;出血,深静脉血栓形成(DVT),和肺栓塞筛查;并根据机构方案进行随访评估.数据分析从2023年9月28日至2024年6月4日进行。
■主要研究结果测量是抗凝血酶III水平与创伤患者结果之间的关联，包括无呼吸机日，没有医院的日子,重症监护病房（ICU）-免费天数，出血,静脉血栓栓塞事件,和死亡率。
■292名患者的平均年龄（SD）为54.4（19.0）岁，其中包括211名男性（72.2％）。抗凝血酶III缺乏症患者的平均（SD）无呼吸机天数较少（27.8[5.1]vs29.6[1.4]；P=.0003），无医院天数（20.3[8.2]vs24.0[5.7]；P=1.37×10-6），与无缺陷患者相比，无ICU天数（25.7[4.9]vs27.7[2.3]；P=9.38×10-6）。抗凝血酶III缺乏还与进行性颅内出血（21.1％[133中的28]比6.3％[159中的10]；P=.0003）和血小板减少症（24.8％[133中的33]比5.0％[159中的8]；P=1.94×10-6）的发生率更高。虽然抗凝血酶III缺乏与DVT没有显著关联,与未发生DVT的患者相比,发生DVT的患者的抗凝血酶III水平下降更为剧烈.
■在这项创伤患者的队列研究中，抗凝血酶III缺乏与更严重的损伤相关，出血增加，死亡率上升，以及更少的无呼吸机，无医院,无ICU日虽然这是一个联想研究,这些数据提示抗凝血酶III水平可能有助于创伤患者的风险评估.
