The recent time trend of outcomes of disseminated intravascular coagulation in Japan: an observational study based on a national administrative database.
The aim of this study is to investigate the recent trend over time of outcomes of patients with disseminated intravascular coagulation (DIC) based on the Japanese administrative database. A total of 34,711 patients with DIC had been referred to 1,092 hospitals from 2010 to 2012 in Japan. We collected patients' data from the administrative database to compare in-hospital mortality within 14 and 28 days between periods. The study periods were categorized into three groups: 2010 (n = 8,382), 2011 (n = 13,372), and 2012 (n = 12,957). These analyses were performed according to the underlying diseases associated with DIC. The in-hospital mortality within 14 or 28 days of DIC patients with infectious diseases decreased between 2010 and 2012 (within 14 days: 20.4 vs. 18.1 vs. 17.9 %, P = 0.009; within 28 days: 31.1 vs. 28.7 vs. 27.7%, P = 0.003; respectively). Multiple logistic regressions also showed that the period was associated with in-hospital mortality of DIC patients with infectious diseases. The odds ratios of 2011 and 2012 for in-hospital mortality within 14 days were 0.86 [95% confidence intervals (CI) 0.77-0.97] and 0.84 (95% CI 0.75-0.94) whereas those for in-hospital mortality within 28 days were 0.89 (95% CI 0.81-0.98) and 0.83 (95% CI 0.76-0.92), respectively. However, there were no significant differences in mortality of patients with DIC associated with other underlying diseases between 2010 and 2012. This study demonstrated that in-hospital mortality of DIC patients with infectious diseases gradually improved between 2010 and 2012 in Japan.
Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan, amurata@med.uoeh-u.ac.jp.
Atsuhiko
A
Murata
Kohji
K
Okamoto
Toshihiko
T
Mayumi
Keiji
K
Muramatsu
Shinya
S
Matsuda
D005260:Female; D006801:Humans; D008297:Male; D016208:Databases, Factual; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000401:mortality / Q000628:therapy; D017052:Hospital Mortality; D007239:Infections / Q000150:complications / Q000401:mortality / Q000628:therapy; D007564:Japan / Q000453:epidemiology; D009313:National Health Programs; D012042:Registries; D013997:Time Factors