Clinical study of prognostic factors of severe sepsis, septic shock using combination therapy of polymyxin B immobilized fiber direct hemoperfusion (PMX-DHP) and continuous hemodiafiltration (CHDF)

Abstract

The aim of this study is the optimization of the endotoxin adsorbent apheresis with continuous hemodiafiltration combination method and to find out which factors are significant at the prognosis. The targets are 59 cases (male: 22, female: 37, average age: 70.3±12.0 years) had a diagnosis of septic shock or severe sepsis at our hospital intensive care units, and treated with endotoxin adsorptive removal therapy combined method of the continuous hemodiafiltration during the period from October 2012 to March 2015. The survival rate of the 28 days of whole target case was 65.3％. Data analysis using univariate analysis selects the six factors (P＜0.05); APACHE Ⅱ score (≧25), SOFA score (≧10), Catecholamine Index rate of change (%) (≧0), blood lactic acid value (≧4mmol/L), blood lactate value change rate (%) (＞0), and platelet counts (≦12×10⁴μL). Data analysis using multivariate analysis selected as an four independent prognostic factors (P＜0.05) in the order of significant difference establishment using the results of Stepwise method; Catecholamine Index rate of change (%) (≧0), APACHE Ⅱ score (≧25), blood lactate value change rate (%) (＞0), platelet counts (≦12×10⁴μL) using the Cox proportional Hazard model.