title: Potential Survival Benefit of Polymyxin B Hemoperfusion in Septic Shock Patients on Continuous Renal Replacement Therapy: A Propensity-Matched Analysis.
abstract: OBJECTIVE
  We assessed the survival benefit of polymyxin B hemoperfusion (PMX) in septic shock patients starting continuous renal replacement therapy (CRRT), who are known to have an increased rate of mortality.
  
  
  METHODS
  Adult patients in the Japanese diagnosis procedure combination database satisfying the following criteria were enrolled: hospitalized in 2007-2012; diagnosed as having sepsis; required noradrenaline and/or dopamine; and started CRRT in intensive care unit. Propensity scores for receiving PMX were created from patient and hospital characteristics.
  
  
  RESULTS
  Of 3,759 eligible patients, 1,068 received PMX. Propensity-score matching produced a matched cohort of 978 pairs. The 28-day mortality was 40.2% (393/978) in the PMX group and 46.8% (458/978) in the control group (p = 0.003). Logistic regression analysis revealed a significant association between the use of PMX and decreased 28-day mortality (adjusted OR 0.75; 95% CI 0.62-0.91).
  
  
  CONCLUSIONS
  This large retrospective study suggests that septic shock patients starting CRRT may benefit from PMX.
authors.affiliation: Department of Hemodialysis and Apheresis, School of Public Health, The University of Tokyo Hospital, Tokyo, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Iwagami
authors.forename: Hideo
authors.initials: H
authors.lastname: Yasunaga
authors.forename: Eisei
authors.initials: E
authors.lastname: Noiri
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
authors.forename: Takehiro
authors.initials: T
authors.lastname: Matsubara
authors.forename: Naoki
authors.initials: N
authors.lastname: Yahagi
authors.forename: Masaomi
authors.initials: M
authors.lastname: Nangaku
authors.forename: Kent
authors.initials: K
authors.lastname: Doi
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D006464:Hemoperfusion / Q000379:methods / Q000401:mortality; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011112:Polymyxin B / Q000627:therapeutic use*; D057216:Propensity Score; D017582:Renal Replacement Therapy / Q000379:methods; D012189:Retrospective Studies; D012772:Shock, Septic / Q000401:mortality* / Q000628:therapy*; D016019:Survival Analysis
chemical_list: D011112:Polymyxin B