Recombinant soluble thrombomodulin for postoperative disseminated XXXX .

@entity1 @entity5642 @entity298 @entity1851
BACKGROUND: Thrombomodulin is a thrombin receptor on the endothelial cell surface that plays an important role in the regulation of @entity5642 . The purpose of this study was to evaluate the efficacy and safety of treatment with recombinant @entity1 soluble thrombomodulin (rhTM) for @entity1 with @entity5642 ( @entity5642 ) associated with gastroenterological surgery. MATERIALS AND METHODS: From April 2011-September 2013, 201 @entity1 with @entity5642 associated with gastroenterological surgery were treated in 16 institutions in Kumamoto, Japan. The @entity1 were diagnosed according to the Japanese Association for Acute Medicine @entity5642 scoring system. The clinical course, mortality rate at 28  d, and adverse events were evaluated retrospectively. RESULTS: Forty-five @entity1 were excluded because they did not meet the Japanese Association for Acute Medicine @entity5642 criteria or had an insufficient duration of drug administration. Thus, 156 @entity1 were analyzed. Of these @entity1 , 107 received rhTM at the discretion of the attending surgeon and 49 did not. The most common reason for surgery in both groups was @entity298 due to perforation of the colon. Within 7  d, the platelet count, prothrombin time-international normalized ratio, @entity5642 score, neutrophil count, and @entity1851 level significantly improved in the rhTM group compared with those in the control. Treatment with rhTM was significantly associated with reduced inhospital mortality at 28  d. The incidence of adverse events did not differ between the two groups. CONCLUSIONS: Therapy with rhTM may be associated with reduced inhospital mortality in @entity1 with septic @entity5642 associated with gastroenterological surgery without increasing adverse events.
