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Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study

BACKGROUND: The purpose of this study was to investigate whether polymyxin B hemoperfusion (PMX-HP) improves the survival of patients with septic shock. METHODS: This was a retrospective, multicenter study conducted on patients treated during a 3-year period. We performed propensity-score analyses o...

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Autores principales: Nakamura, Yoshihiko, Kitamura, Taisuke, Kiyomi, Fumiaki, Hayakawa, Mineji, Hoshino, Kota, Kawano, Yasumasa, Yamasaki, Reiko, Nishida, Takeshi, Mizunuma, Mariko, Ishikura, Hiroyasu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463489/
https://www.ncbi.nlm.nih.gov/pubmed/28592318
http://dx.doi.org/10.1186/s13054-017-1712-3
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author Nakamura, Yoshihiko
Kitamura, Taisuke
Kiyomi, Fumiaki
Hayakawa, Mineji
Hoshino, Kota
Kawano, Yasumasa
Yamasaki, Reiko
Nishida, Takeshi
Mizunuma, Mariko
Ishikura, Hiroyasu
author_facet Nakamura, Yoshihiko
Kitamura, Taisuke
Kiyomi, Fumiaki
Hayakawa, Mineji
Hoshino, Kota
Kawano, Yasumasa
Yamasaki, Reiko
Nishida, Takeshi
Mizunuma, Mariko
Ishikura, Hiroyasu
author_sort Nakamura, Yoshihiko
collection PubMed
description BACKGROUND: The purpose of this study was to investigate whether polymyxin B hemoperfusion (PMX-HP) improves the survival of patients with septic shock. METHODS: This was a retrospective, multicenter study conducted on patients treated during a 3-year period. We performed propensity-score analyses of the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study database. The study included data on 1723 patients with septic shock aged 16 years or older. Furthermore, we divided patients into to PMX-HP- and non-PMX-HP-treated groups. The primary endpoint was all-cause hospital mortality; secondary endpoints included intensive care unit (ICU) mortality and number of ICU-free days (ICUFDs) in the first 28 days. RESULTS: Of 1,723 eligible patients, 522 had received PMX-HP. Propensity score matching created 262 matched pairs (i.e., 262 patients in each of the non-PMX-HP and PMX-HP groups). The proportion of all-cause hospital mortality was significantly lower in the PMX-HP group than in the non-PMX-HP group (32.8% vs. 41.2%; odds ratio (OR): 0.681; 95% confidence interval (CI): 0.470–0.987; P = 0.042). The number of ICUFD in the first 28 days was significantly higher in the PMX-HP group than in the non-PMX-HP group (18 (0-22) vs. 14 (0-22) days, respectively; P = 0.045). On the other hand, there was no significant difference in ICU mortality between the two groups (21.8% vs. 24.4%; OR: 0.844; CI: 0.548–1.300; P = 0.443). CONCLUSIONS: Our results strongly suggest that PMX-HP reduces all-cause hospital mortality and length of ICU stay in patients with septic shock. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-017-1712-3) contains supplementary material, which is available to authorized users.
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spelling pubmed-54634892017-06-08 Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study Nakamura, Yoshihiko Kitamura, Taisuke Kiyomi, Fumiaki Hayakawa, Mineji Hoshino, Kota Kawano, Yasumasa Yamasaki, Reiko Nishida, Takeshi Mizunuma, Mariko Ishikura, Hiroyasu Crit Care Research BACKGROUND: The purpose of this study was to investigate whether polymyxin B hemoperfusion (PMX-HP) improves the survival of patients with septic shock. METHODS: This was a retrospective, multicenter study conducted on patients treated during a 3-year period. We performed propensity-score analyses of the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study database. The study included data on 1723 patients with septic shock aged 16 years or older. Furthermore, we divided patients into to PMX-HP- and non-PMX-HP-treated groups. The primary endpoint was all-cause hospital mortality; secondary endpoints included intensive care unit (ICU) mortality and number of ICU-free days (ICUFDs) in the first 28 days. RESULTS: Of 1,723 eligible patients, 522 had received PMX-HP. Propensity score matching created 262 matched pairs (i.e., 262 patients in each of the non-PMX-HP and PMX-HP groups). The proportion of all-cause hospital mortality was significantly lower in the PMX-HP group than in the non-PMX-HP group (32.8% vs. 41.2%; odds ratio (OR): 0.681; 95% confidence interval (CI): 0.470–0.987; P = 0.042). The number of ICUFD in the first 28 days was significantly higher in the PMX-HP group than in the non-PMX-HP group (18 (0-22) vs. 14 (0-22) days, respectively; P = 0.045). On the other hand, there was no significant difference in ICU mortality between the two groups (21.8% vs. 24.4%; OR: 0.844; CI: 0.548–1.300; P = 0.443). CONCLUSIONS: Our results strongly suggest that PMX-HP reduces all-cause hospital mortality and length of ICU stay in patients with septic shock. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-017-1712-3) contains supplementary material, which is available to authorized users. BioMed Central 2017-06-07 /pmc/articles/PMC5463489/ /pubmed/28592318 http://dx.doi.org/10.1186/s13054-017-1712-3 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Nakamura, Yoshihiko
Kitamura, Taisuke
Kiyomi, Fumiaki
Hayakawa, Mineji
Hoshino, Kota
Kawano, Yasumasa
Yamasaki, Reiko
Nishida, Takeshi
Mizunuma, Mariko
Ishikura, Hiroyasu
Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study
title Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study
title_full Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study
title_fullStr Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study
title_full_unstemmed Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study
title_short Potential survival benefit of polymyxin B hemoperfusion in patients with septic shock: a propensity-matched cohort study
title_sort potential survival benefit of polymyxin b hemoperfusion in patients with septic shock: a propensity-matched cohort study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463489/
https://www.ncbi.nlm.nih.gov/pubmed/28592318
http://dx.doi.org/10.1186/s13054-017-1712-3
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