Recombinant Human Soluble Thrombomodulin And Short-term Mortality Of Sepsis Patients With Disseminated Intravascular Coagulation: A Meta-analysis

Objective: Several studies have demonstrated that recombinant human soluble thrombomodulin(rh TM)has potential advantages for the treatment of patients with sepsis complicated by disseminated intravascular coagulation(DIC).However,whether injection of rh TM can affect the mortality of those patients in clinical treatment remains controversial.Therefore,we conducted a meta-analysis to evaluate the clinical efficacy for patients with sepsis complicated by DIC.Methods: The Pub Med,Web of Science,Embase,and Cochrane Library databases were searched for relevant articles that met the inclusion criteria through March 2017.Reference lists of the retrieved articles were also reviewed.The 28 or 30 days mortality and bleeding risk after using rh TM were evaluated.Results: Ten observational studies and three randomized controlled trials(RCTs)involving 18,380 patients were included in this meta-analysis.The risk ratio(RR)for the 28 or 30 days mortality was 0.83(95% CI,0.64-1.07)in RCT studies and 0.96(95% CI,0.92-1.01)in observational studies.There were no significant differences in the bleeding risk between the rh TM group and control group.Conclusion: Based on the current studies,using rh TM for the treatment of sepsis patients complicated with DIC does not decrease the short-term mortality of those patients.More high quality RCT studies need to be performed to confirm this finding.