TY - JOUR
T1 - Results of the 2018 Japan Society for Blood Purification in Critical Care survey
T2 - current status and outcomes
AU - Abe, Masanori
AU - Shiga, Hidetoshi
AU - Tatsumi, Hiroomi
AU - Endo, Yoshihiro
AU - Kikuchi, Yoshihiko
AU - Suzuki, Yasushi
AU - Doi, Kent
AU - Nakada, Taka Aki
AU - Nagafuchi, Hiroyuki
AU - Hattori, Noriyuki
AU - Hirohashi, Nobuyuki
AU - Moriguchi, Takeshi
AU - Yamaga, Osamu
AU - Nishida, Osamu
N1 - Funding Information:
We thank the members of the committee of the JSBPCC registry for all their efforts, as well as the staff members at the participating facilities. In particular, we thank the following medical professionals and hospitals: Yoshifumi Hamasaki, Masanomi Nangaku, The University of Tokyo Hospital; Koji Tomori, Hirokazu Okada, Saitama Medical University Hospital; Kosuke Sekine, Kameda Medical Center; Ryokichi Yasumori, Makoto Arima, Oita Kouseiren Tsurumi Hospital; Kazuyoshi Hori, Masahiro Inoue, Katori Omigawa Medical Center; Tetsuji Kakegawa, Uichi Ikeda, Nagano Municipal Hosipital; Toshiaki Kurasako, Kengo Nishimura, Japanese Red Cross Society Himeji Hospital; Koji Goto, Yoshifumi Ohchi, Teruo Sakamoto, Oita University Hospital; Toshio Shiratori, Tomohiro Takahata, Almeida Memorial Hospital; Isao Tsukamoto, Yusuke Watanabe, Saitama Medical University International Medical Center; Motoki Yonekawa, Kazutaka Kukita, Sapporo Hokuyu Hospital; Kiyohiko Kinjoh, Okinawa Kyodo Hospital; Tomoyuki Nakamura, Fujita Health University Hospital; Makoto Kobayashi, TAJIMA Emergency & Critical Care Medical Center; Tomomi Matsuoka, Nobuteru Takao, Nihon University Itabashi Hospital; Shotaro Naito, Atsushi Ohkubo, Tokyo Medical and Dental University Hospital; Nobuya Kitamura, Kimitsu Chuo Hospital; Harumichi Higashi, Masashi Takeuchi, St. Mary's Hospital; Hiroshi Shibahara, Sagamihara Kyodo Hospital; Osamu Takasu, Nobuhisa Hirayu, Kurume University Hospital; Tomonari Ogawa, Yuki Kanayama, Saitama Medical Center, Saitama Medical University; Mitsuteru Koizumi, Kyoto Medical Center; Takahiro Miki, Tomohide Eguchi, Nihon University Hospital; Yutaka Furukawa, Chiba University Graduate School of Medicine; Toshiaki Ikeda, Tokyo Medical University Hachioji Medical center; Koji Oiwa, Japan Community Healthcare Organization Yokohama Chuo Hospital; Shigeo Negi, Takuro Yano, Wakayama Medical University; Kenichiro Asano, Mariko Sawada, Kurashiki Central Hospital; Daisuke Katagiri, Center Hospital of National Center for Global Health and Medicine; Shuzo Kobayashi, Hidekazu Moriya, Shonan Kamakura General Hospital; Yoshiki Masuda, Sapporo Medical University School of Medicine; Fumika Taki, Masaaki Nakayama, St. Luke’s International Hospital; Masataka Nakaoji, Kanto Central Hospital; Yoshiyuki Morishita, Kiyonori Ito, Saitama Medical Center, Jichi Medical University; Toshifumi Sakaguchi, Rinku General Medical Center; Takahiko Sato, Gyoda General Hospital; Kensuke Nakamura, Naoki Akashi, Hitachi General Hospital; Yuji Yamagami, Kazushi Maruo, Hyogo Prefectural Amagasaki General Medical Center; Tomoaki Hashida, Eizo Watanabe, Eastern Chiba Medical Center; Tomoki Furuya, Akita University Hospital; Kojiro Nagai, Satoshi Tanaka, Shizuoka General Hospital.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: The Japan Society for Blood Purification in Critical Care (JSBPCC) has reported survey results on blood purification therapy (BPT) for critically ill patients in 2005, 2009, and 2013. To clarify the current clinical status, including details of the modes used, treated diseases, and survival rate, we conducted this cohort study using data from the nationwide JSBPCC registry in 2018. Methods: We analyzed data of 2371 patients who underwent BPT in the intensive care units of 43 facilities to investigate patient characteristics, disease severity, modes of BPTs, including the dose of continuous renal replacement therapy (CRRT) and hemofilters, treated diseases, and the survival rate for each disease. Disease severity was assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores. Results: BPT was performed 2867 times in the 2371 patients. Mean APACHE II and SOFA scores were 23.5 ± 9.4 and 10.0 ± 4.4, respectively. The most frequently used mode of BPT was CRRT (67.4%), followed by intermittent renal replacement therapy (19.1%) and direct hemoperfusion with the polymyxin B-immobilized fiber column (7.3%). The most commonly used anticoagulant was nafamostat mesilate (78.6%). Among all patients, the 28-day survival rate was 61.7%. CRRT was the most commonly used mode for many diseases, including acute kidney injury (AKI), multiple organ failure (MOF), and sepsis. The survival rate decreased according to the severity of AKI (P = 0.001). The survival rate was significantly lower in patients with multiple organ failure (MOF) (34.6%) compared with acute lung injury (ALI) (48.0%) and sepsis (58.0%). Multivariate logistic regression analysis revealed that sepsis, ALI, acute liver failure, cardiovascular hypotension, central nervous system disorders, and higher APACHE II scores were significant predictors of higher 28-day mortality. Conclusion: This large-scale cohort study revealed the current status of BPT in Japan. It was found that CRRT was the most frequently used mode for critically ill patients in Japan and that 28-day survival was lower in those with MOF or sepsis. Further investigations are required to clarify the efficacy of BPT for critically ill patients. Trial Registration: UMIN000027678.
AB - Background: The Japan Society for Blood Purification in Critical Care (JSBPCC) has reported survey results on blood purification therapy (BPT) for critically ill patients in 2005, 2009, and 2013. To clarify the current clinical status, including details of the modes used, treated diseases, and survival rate, we conducted this cohort study using data from the nationwide JSBPCC registry in 2018. Methods: We analyzed data of 2371 patients who underwent BPT in the intensive care units of 43 facilities to investigate patient characteristics, disease severity, modes of BPTs, including the dose of continuous renal replacement therapy (CRRT) and hemofilters, treated diseases, and the survival rate for each disease. Disease severity was assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores. Results: BPT was performed 2867 times in the 2371 patients. Mean APACHE II and SOFA scores were 23.5 ± 9.4 and 10.0 ± 4.4, respectively. The most frequently used mode of BPT was CRRT (67.4%), followed by intermittent renal replacement therapy (19.1%) and direct hemoperfusion with the polymyxin B-immobilized fiber column (7.3%). The most commonly used anticoagulant was nafamostat mesilate (78.6%). Among all patients, the 28-day survival rate was 61.7%. CRRT was the most commonly used mode for many diseases, including acute kidney injury (AKI), multiple organ failure (MOF), and sepsis. The survival rate decreased according to the severity of AKI (P = 0.001). The survival rate was significantly lower in patients with multiple organ failure (MOF) (34.6%) compared with acute lung injury (ALI) (48.0%) and sepsis (58.0%). Multivariate logistic regression analysis revealed that sepsis, ALI, acute liver failure, cardiovascular hypotension, central nervous system disorders, and higher APACHE II scores were significant predictors of higher 28-day mortality. Conclusion: This large-scale cohort study revealed the current status of BPT in Japan. It was found that CRRT was the most frequently used mode for critically ill patients in Japan and that 28-day survival was lower in those with MOF or sepsis. Further investigations are required to clarify the efficacy of BPT for critically ill patients. Trial Registration: UMIN000027678.
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U2 - 10.1186/s41100-022-00445-0
DO - 10.1186/s41100-022-00445-0
M3 - Article
AN - SCOPUS:85141688232
VL - 8
JO - Renal Replacement Therapy
JF - Renal Replacement Therapy
SN - 2059-1381
IS - 1
M1 - 58
ER -