Hazard ratio of sepsis patients treated with extracorporeal detoxification methods

Georgijs Moisejevs, Janis Seilis, Armands Pocs, Eva Bormane, Anda Grigane, Oļegs Šuba, Alise Silova, Linda Gailīte, Ģirts Briģis

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Introduction: Sepsis is a life-threatening and often fatal syndrome. Most of the patients with sepsis are treated in the intensive
care units (ICU) and often requires use of different organ replacement therapy technologies, including mechanical lung ventilation
(MLV) and continuous renal replacement therapy (CRRT). CRRT
in the case of sepsis is often used as extracorporeal detoxification
method and it is initiated before patients develop absolute indications. So far it is not clear, whether the use of CRRT as the method
of detoxification for sepsis patients does influence the indicators
of recovery.
Objective: To describe hazard ratio and potentially associated
risk factors in sepsis patients treated with CRRT.
Materials and Methods: A retrospective study of 110 patients
(53 males, median of age – 67.8 years) (the interquartile range
(IQR) 57.8–75.0) who were treated at Riga East Clinical University Hospital’s Clinic of Toxicology and Sepsis with diagnosis “sepsis” during the time period from 2014 to 2017 and in whom extracorporeal detoxification methods were used. SPSS software was
used to analyze data, and hazard ratio (HR) as well as p-value were
calculated using Cox regression method.
Results: 74 of all 110 treated patients that were included in this
study died. Median of time spent at ICU was 6 days (IQR 2.8–11.0),
median of time of hospitalization was 12 days (IQR 3.8–23.3), median of time on MLV was 3 days (IQR 1.3–7.0) and median time
on CRRT was 2 days (1.0–4.0).
In unifactorial Cox regression analysis factors associated to
death are as follows: male gender (HR = 1.9, p = 0.006), virus hepatitis C coinfection (HR = 2.8, p = 0.048), no surgical intervention
during the treatment (HR = 2.3, p = 0.003), SOFA score (HR = 1.2,
p = 0.001), use of MLV (HR = 2.5, p = 0.001) and time on MLV
(HR = 0.9, p = 0.001), but not other comorbidities, patient age and
sepsis origin. In multifactorial analysis only two factors were associated with death: SOFA score (HR = 1.1, p = 0.055) and use of
MLV (HR = 2.0, p = 0.027).
Conclusions: The death rate among sepsis patients in whom
CRRT was used is very high. Two independent predictors of adverse outcome are SOFA score and severe pulmonary insufficiency which needs use of MLV.
Original languageEnglish
Pages (from-to)170
JournalBlood Purification
Volume46
Issue number3
Publication statusPublished - 2018
Event36th Vicenza Course on AKI & CRRT - Vicenza, Italy
Duration: 12 Jun 201814 Jun 2018

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 3.4. Other publications in conference proceedings (including local)

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