| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Disseminated intravascular coagulation as a prognostic factor in heatstroke: a retrospective cohort study based on Japanese insurance claims. |
| 掲載誌名 | 正式名：Frontiers in medicine 略 称：Front Med (Lausanne) ISSNコード：2296858X/2296858X |
| 掲載区分 | 国外 |
| 巻・号・頁 | 13,pp.1941386 |
| 著者・共著者 | Hiroyuki Koami, Yutaro Furukawa, Hiroki Ushijima, Daisuke Muroya, Tadashi Matsuoka, Takaaki Totoki, Kenji Kandori, Takahiro Oishi, Kasumi Satoh, Yutaka Umemura, Kazuma Yamakawa, Mineji Hayakawa, Kohji Okamoto, Yuichiro Sakamoto |
| 発行年月 | 2026/09 |
| 概要 | PURPOSE:Heatstroke is an emerging global health concern, particularly among the elderly. Disseminated intravascular coagulation (DIC) complicates about 20% of these cases and contributes to poor outcomes. The JAAM-2 DIC score, which excludes SIRS, has been validated in sepsis. However, its utility in heatstroke, a condition sharing pathophysiological features with sepsis, remains unexamined. To evaluate the association between heatstroke-associated DIC, defined by JAAM-2 criteria, and clinical outcomes, using a nationwide Japanese database of medical claims.METHODS:We conducted a retrospective analysis using data from Japanese health insurance claims from 2014 to 2023. Among 2,633 adult patients admitted with heatstroke, 606 cases with complete DIC data on admission were included. Patients were categorized into DIC (n = 76) and non-DIC groups (n = 530) based on DIC criteria. Multivariate logistic regression analysis was performed to evaluate DIC as a prognostic indicator of poor outcomes.RESULTS:The DIC group was older and exhibited higher rates of impaired consciousness, hepatic and renal dysfunction, bleeding/thrombotic complications, and mortality. Kaplan-Meier analysis showed significantly lower 28-day survival in the DIC group (log-rank P < 0.0001). In the multivariate model, DIC remained associated with in-hospital mortality (odds ratio 1.566, 95% CI 1.147-2.140, P = 0.004). Sub-analyses showed three factors strongly related to poor prognosis: initial DIC score ≥4, FDP sub-score of 3 at presentation, and D1+/D2 + or D1-/D2 + pattern on day 2.CONCLUSION:JAAM-2 DIC is associated with poor clinical outcomes in patients with heatstroke, supporting the clinical importance of recognizing coagulopathy in this population. |
| DOI | 10.3389/fmed.2026.1941386 |
| 文献番号 | WOS:001879041000001 |
| PMID | 42761051 |