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An Observational Study to Learn About the Occurrence of Disseminated Intravascular Coagulation Among Adults With Sepsis in Japan

Active, not recruiting
Conditions
Sepsis
Disseminated Intravascular Coagulation
Interventions
Other: No study intervention
Registration Number
NCT06373159
Lead Sponsor
Bayer
Brief Summary

This is an observational study in which data already collected from people with sepsis (blood poisoning) and/or disseminated intravascular coagulation (DIC) are studied.

In observational studies, only observations are made without participants receiving any advice or changes to their healthcare.

DIC is a serious blood disorder that can cause clots throughout the body, blocking blood vessels. People who have sepsis or cancer are at a higher risk of developing DIC.

To find a treatment that works well for people with DIC associated with sepsis, it is important to know about its occurrence, treatments people receive, and their outcomes. Japan is the only country that has officially approved medicines for DIC including a few newer medicines that prevent extensive blood clotting.

In this study, researchers will assess patient data from a hospital database in Japan.

The main purpose of this study is to learn more about how many adults develop DIC related to sepsis, thrombocytopenic sepsis (sudden decrease in the number of platelets in the blood), or septic shock (dangerously low blood pressure) in Japan every year.

To learn about this, researchers will collect the following information:

* The number of participants who developed DIC 14 days, 21 days and 28 days after their sepsis diagnosis

* The grading scores given to the participants which are used to assess the likelihood, cause, severity, treatment plan, and outcome of DIC (including scores called JAAM, ISTH, MHLW, and/or SOFA scores)

* The number of days between diagnosis of sepsis and the beginning of DIC

Researchers will study the data collected between June 2018 and June 2023. The data will come from TXP Medical, which collects data through the hospital health information system of 7 selected hospitals for this study across Japan.

In this study, only available data from routine care are collected.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
5740
Inclusion Criteria
  • Sepsis patient cohort

    • Sepsis patients

    • Age ≥18 years

    • Subgroups:

      • Sepsis with thrombocytopenia patient cohort
      • Septic shock patient cohort
  • Sepsis-associated DIC patient cohort

    • DIC patients in sepsis patient cohort

    • Subgroups:

      • Organ failure: kidney (Serum creatinine (SCr) < 1.2 mg/dl and ≥ 1.2 mg/dl)

      • Organ failure: liver (bilirubin < 1.2 mg/dl and ≥ 1.2 mg/dl)

      • Organ failure: cardiovascular (with and without catecholamine or vasopressin)

      • With low molecular weight (LMW) heparins, unfractionated heparins, and both

      • With and without DIC treatment

        • Priority 1_Anticoagulants specifically used in Japan (recombinant antithrombin, recombinant thrombomodulin, human anti-thrombin III)
        • Priority 1 + Priority 2_Drugs for sepsis-associated DIC (LMW heparins, unfractionated heparins, protease inhibitors)
        • Priority 1 + Priority 2 + Priority 3_antibiotics (antifungals), and/or steroids
  • Non-sepsis-associated DIC patient cohort

    • Hematopoietic malignant tumor patients
    • DIC patients
    • Age ≥18 years
Exclusion Criteria
  • Sepsis patient cohort: None
  • Sepsis-associated DIC patient cohort: None
  • Non-sepsis-associated DIC patient cohort: Sepsis patients

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Sepsis patient cohortNo study interventionPatients diagnosed with sepsis in patient inclusion period, regardless of etiology, including subgroups: sepsis with thrombocytopenia patient cohort and septic shock patient cohort
Non-sepsis-associated DIC patient cohortNo study interventionDIC patients without sepsis in patient inclusion period
Sepsis-associated DIC patient cohortNo study interventionSepsis patients with onset of DIC in the patient record in patient inclusion period
Primary Outcome Measures
NameTimeMethod
Incidence of DIC assessed at 14 days, 21 days and 28 days of the patient follow upRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

DIC: disseminated intravascular coagulation

Distribution of JAAM DIC scoreRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

The Japanese Association for Acute Medicine (JAAM) DIC scoring algorithm includes a number of variables but in addition specific criteria for evidence of a Systemic Inflammatory Response Syndrome (SIRS). JAAM DIC score \>= 4 supports a diagnosis of DIC. DIC: disseminated intravascular coagulation

Distribution of ISTH DIC scoreRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

The International Society on Thrombosis Haemostasis (ISTH) DIC score is a simple scoring system produced by the ISTH group for the diagnosis of DIC depending on the Platelet count, the PT, the fibrinogen level and critically the FDP/D-Dimer results. A total score of ≥5 = DIC as long as the score is associated with a clinical disorder known to cause DIC. DIC: disseminated intravascular coagulation

Distribution of SOFA scoreRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

The Sequential Organ Failure Assessment (SOFA) score is a scoring system based on performance of respiratory, coagulation, liver, cardiovascular, central nervous system, and kidney. The higher the SOFA score, the higher the likely mortality. DIC: disseminated intravascular coagulation

Distribution of MHLW DIC scoreRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

The Japanese Ministry of Health, Labor and Welfare (MHLW) DIC score is a scoring system for the diagnosis of overt DIC. MHLW DIC score ≥7 is defined as DIC. DIC: disseminated intravascular coagulation

Days from sepsis diagnosis to the onset of DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

DIC: disseminated intravascular coagulation

Secondary Outcome Measures
NameTimeMethod
Number of participants per clinical characteristics in subgroup of patients who developed sepsis-associated DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

DIC: disseminated intravascular coagulation

Incidence rates of clinical outcomes in subgroup of patients who developed sepsis-associated DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

Clinical outcomes include thrombosis, major bleeding, organ failures, death, ICUs admission during the index hospitalization, discharge during the index hospitalization, length of index hospitalization.

Number of participants per clinical characteristics after the onset of DIC in patients with non-sepsis-associated DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

DIC: disseminated intravascular coagulation

Incidence rates of clinical outcomes after the onset of DIC in patients with non-sepsis-associated DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

Clinical outcomes include thrombosis, major bleeding, organ failures, death, ICUs admission during the index hospitalization, discharge during the index hospitalization, length of index hospitalization.

Number of participants per clinical characteristicsRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

Clinical characteristics (e.g., demographics, comorbidities, medical history) in patients with sepsis, thrombocytopenic sepsis and septic shock, respectively; in patients with sepsis in different definitions (diagnosis codes, laboratory values, and procedure codes); at the onset of DIC in patients who developed sepsis-associated DIC. DIC: disseminated intravascular coagulation

Incidence rates of clinical outcomes assessed in patients with sepsis-associated DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

Clinical outcomes are assessed at 14 days, 28 days, 60 days, 183 days, 365 days (1 year) and 730 days (2 years) of follow up. Clinical outcomes include thrombosis, major bleeding, organ failures, death, ICUs admission during the index hospitalization, discharge during the index hospitalization, length of index hospitalization. DIC: disseminated intravascular coagulation

Number of participants per DIC treatment patterns in patients with sepsis-associated DIC following the onset of DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

DIC: disseminated intravascular coagulation

Number of participants per treatment patterns in subgroup of patients who developed sepsis-associated DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

DIC: disseminated intravascular coagulation

Number of participants per treatment patterns after the onset of DIC in patients with non-sepsis-associated DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

DIC: disseminated intravascular coagulation

Cumulative incidences of clinical outcomes assessed in patients with sepsis-associated DICRetrospective analysis of real world data between 01 JUN 2018 and 01 JUN 2023

Clinical outcomes are assessed at 14 days, 28 days, 60 days, 183 days, 365 days (1 year) and 730 days (2 years) of follow up. Clinical outcomes include thrombosis, major bleeding, organ failures, death, ICUs admission during the index hospitalization, discharge during the index hospitalization, length of index hospitalization. DIC: disseminated intravascular coagulation

Trial Locations

Locations (1)

Bayer

🇯🇵

Tokyo, Japan

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