Mortality Risk Prediction in Abdominal Septic Shock Treated with Polymyxin-B Hemoperfusion: A Retrospective Cohort Study

Endotoxin, a component of the cell membrane of gram-negative bacteria, is a trigger for dysregulated inflammatory response in sepsis. Extracorporeal purification of endotoxin, through adsorption with polymyxin B, has been studied as a therapeutic option for sepsis. Previous studies suggest that it c...

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Bibliographic Details
Published in:Journal of personalized medicine 2023-06, Vol.13 (7), p.1023
Main Authors: Garcia-Ramos, Sergio, Caamaño, Estrela, Rodríguez Benítez, Patrocinio, Benito, Pilar, Calvo, Alberto, Ramos, Silvia, Power, Mercedes, Garutti, Ignacio, Piñeiro, Patricia
Format: Article
Language:English
Subjects:
Abdomen
Antibiotics
Cell membranes
Clinical medicine
Cohort analysis
Gram-negative bacteria
Health aspects
Hospitals
Inflammation
Ischemia
Medical records
Metabolism
Mortality
Patients
Polymyxin B
Precision medicine
Sepsis
Septic shock
Statistical analysis
Wound dehiscence
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Summary:Endotoxin, a component of the cell membrane of gram-negative bacteria, is a trigger for dysregulated inflammatory response in sepsis. Extracorporeal purification of endotoxin, through adsorption with polymyxin B, has been studied as a therapeutic option for sepsis. Previous studies suggest that it could be effective in patients with high endotoxin levels or patients with septic shock of moderate severity. Here, we perform a retrospective, single-centre cohort study of 93 patients suffering from abdominal septic shock treated with polymyxin-B hemoperfusion (PMX-HP) between 2015 and 2020. We compared deceased and surviving patients one month after the intervention using X and Mann-Whitney U tests. We assessed the data before and after PMX-HP with a Wilcoxon single-rank test and a multivariate logistic regression analysis. There was a significant reduction of SOFA score in the survivors. The expected mortality using APACHE-II was 59.62%, whereas in our sample, the rate was 40.9%. We found significant differences between expected mortality and real mortality only for the group of patients with an SOFA score between 8 and 13. In conclusion, in patients with abdominal septic shock, the addition of PMX-HP to the standard therapy resulted in lower mortality than expected in the subgroup of patients with intermediate severity of illness.
ISSN:2075-4426
2075-4426
DOI:10.3390/jpm13071023