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Ulinastatin did not reduce mortality in elderly multiple organ failure patients: a retrospective observational study

Masatoshi Uchida1,2, Toshikazu Abe2,3, Kazuyuki Ono1

  • 1Department of Emergency and Critical Care Medicine Dokkyo Medical University Tochigi Japan.

Acute Medicine & Surgery
|February 16, 2018
PubMed
Abstract

Insights

Ulinastatin did not reduce 28-day mortality in intensive care unit (ICU) patients with multiple organ failure (MOF). This study found no survival benefit, with fewer ICU-free days in the ulinastatin group.

Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Organ Failure Research

Background:

  • Multiple organ failure (MOF) is a critical condition in intensive care units (ICUs).
  • Ulinastatin, a protease inhibitor, is used in some regions for critical illnesses.
  • The efficacy of ulinastatin in MOF patients remains under investigation.

Purpose of the Study:

  • To evaluate the effect of ulinastatin on 28-day mortality in ICU patients with MOF.
  • To assess secondary outcomes including ventilator-free and ICU-free days.
  • To investigate ulinastatin's association with mortality in sepsis-related MOF.

Main Methods:

  • Retrospective observational study of 212 MOF patients in a Japanese tertiary care hospital (2009-2012).
  • Primary outcome: 28-day all-cause mortality.
  • Multivariable regression analysis to assess the association between ulinastatin treatment and outcomes.

Main Results:

  • Ulinastatin was administered to 37% of patients; no significant baseline differences between groups.
  • The ulinastatin group had a higher prevalence of sepsis (44% vs. 22%).
  • Ulinastatin was not associated with 28-day mortality (OR 1.22) or sepsis-related mortality (OR 1.92), but was linked to fewer ICU-free and ventilator-free days.

Conclusions:

  • Ulinastatin showed no association with reduced mortality in elderly MOF patients.
  • The drug was associated with fewer ICU-free and ventilator-free days.
  • Further research may be needed to clarify ulinastatin's role and potential utility in specific patient subgroups.
Keywords:
Multiple organ dysfunction syndromemultiple organ failuresepsissystemic inflammation response syndromeulinastatin

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