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

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Nephrology

Background:

• Endotoxin from gram-negative bacteria triggers inflammatory responses in sepsis.
• Extracorporeal endotoxin adsorption using polymyxin B is a potential sepsis therapy.
• Previous studies suggest efficacy in patients with high endotoxin levels or moderate septic shock.

Purpose of the Study:

• To evaluate the effectiveness of polymyxin-B hemoperfusion (PMX-HP) in patients with abdominal septic shock.
• To compare mortality rates between expected and actual outcomes following PMX-HP treatment.

Main Methods:

• Retrospective, single-centre cohort study of 93 patients with abdominal septic shock treated with PMX-HP (2015-2020).
• Comparison of deceased and surviving patients using X² and Mann-Whitney U tests.
• Assessment of pre- and post-intervention data using Wilcoxon single-rank test and multivariate logistic regression.

Main Results:

• Significant reduction in SOFA score observed in surviving patients.
• Observed mortality rate was 40.9%, lower than the expected APACHE-II mortality of 59.62%.
• Significant difference between expected and real mortality found in patients with SOFA scores between 8 and 13.

Conclusions:

• Addition of PMX-HP to standard therapy for abdominal septic shock may lower mortality.
• PMX-HP demonstrated a survival benefit in the subgroup of patients with intermediate illness severity (SOFA score 8-13).
• Further research is warranted to confirm the role of PMX-HP in specific septic shock populations.