Huang Hongwei, Mo Jiacheng, Jiang Gui, Lu Zheng
Intensive Care Unit, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-Sen University, Nanning, Guangxi, 530022, People's Republic of China.
Intensive care unit, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People's Republic of China.
Int J Gen Med. 2024 Aug 29;17:3765-3777. doi: 10.2147/IJGM.S475186. eCollection 2024.
To evaluate the long-term efficacy and cost-efficiency of blood purification (BP) in severe acute pancreatitis (SAP) through single-center data.
A total of 155 SAP patients were collected and followed up for 6 months. The participants were divided into control (49 cases) and BP group (106 cases) according to whether they received BP treatment or not. The primary outcomes were 6-month mortality, length of hospital stay, and hospitalization costs. Propensity score matching (PSM) analysis was performed based on various factors such as gender, age, etiology, SOFA score, JSS score, and creatinine value on day 1.
There were significant differences in all baseline data between BP and control groups (<0.05). However, there was a significant difference in the mortality, length of hospital stay, hospital costs and infection aggravation rate the in outcome data for 6-months (all <0.05). BP was not considered a death factor in any adjusted models, with -values ranging from 0.81 to 0.93. The results of subgroup analysis after PSM showed that BP mode had no significant impact on prognostic indicators, but the length of ICU stay and total costs were significantly increased (all <0.001). There was no significant difference in mortality among the cases that did not require early intervention after 6 months (=0.487). However, the patients in BP group had longer ICU stays (=0.001) and higher hospitalization costs (<0.001) compared to the control group.
The utilization of BP therapy did not decrease the 6-month mortality in SAP patients. Additionally, BP therapy has a significant impact on the duration of ICU stay or hospitalization expenses. However, the effectiveness and cost-efficiency of this therapy are unsatisfactory, and early intervention does not enhance survival benefits. Furthermore, there was no substantial variation in survival benefits between continuous veno-venous hemofiltration (CVVH) alone and compound BP.
通过单中心数据评估血液净化（BP）在重症急性胰腺炎（SAP）中的长期疗效和成本效益。
共收集155例SAP患者并随访6个月。根据是否接受BP治疗将参与者分为对照组（49例）和BP组（106例）。主要结局指标为6个月死亡率、住院时间和住院费用。基于性别、年龄、病因、序贯器官衰竭评估（SOFA）评分、日本外科协会（JSS）评分和第1天肌酐值等多种因素进行倾向得分匹配（PSM）分析。
BP组和对照组所有基线数据均存在显著差异（<0.05）。然而，6个月结局数据中的死亡率、住院时间、住院费用和感染加重率存在显著差异（均<0.05）。在任何调整模型中，BP均未被视为死亡因素，P值范围为0.81至0.93。PSM后亚组分析结果显示，BP模式对预后指标无显著影响，但重症监护病房（ICU）住院时间和总成本显著增加（均<0.001）。6个月后无需早期干预的病例死亡率无显著差异（P = 0.487）。然而，与对照组相比，BP组患者的ICU住院时间更长（P = 0.001）且住院费用更高（<0.001）。
BP治疗并未降低SAP患者的6个月死亡率。此外，BP治疗对ICU住院时间或住院费用有显著影响。然而，该治疗的有效性和成本效益并不理想，早期干预并未提高生存获益。此外，单纯连续性静脉 - 静脉血液滤过（CVVH）和复合BP之间的生存获益无实质性差异。
