Evaluating the Therapeutic Efficiency and Efficacy of Blood Purification for Treating Severe Acute Pancreatitis: A Single-Center Data Based on Propensity Score Matching

Abstract

Hongwei Huang,1 Jiacheng Mo,2 Gui Jiang,2 Zheng Lu1 1Intensive Care Unit, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-Sen University, Nanning, Guangxi, 530022, People’s Republic of China; 2Intensive care unit, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of ChinaCorrespondence: Zheng Lu, Intensive Care Unit, Guangxi Hospital Division of the First Affiliated Hospital, Sun Yat-sen University, Nanning, Guangxi, 530022, People’s Republic of China, Email [email protected]: To evaluate the long-term efficacy and cost-efficiency of blood purification (BP) in severe acute pancreatitis (SAP) through single-center data.Patients and Methods: 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.Results: There were significant differences in all baseline data between BP and control groups (p< 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 p< 0.05). BP was not considered a death factor in any adjusted models, with p-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 p< 0.001). There was no significant difference in mortality among the cases that did not require early intervention after 6 months (p=0.487). However, the patients in BP group had longer ICU stays (p=0.001) and higher hospitalization costs (p< 0.001) compared to the control group.Conclusion: 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.Keywords: severe acute pancreatitis, blood purification, long-term efficacy, cost-efficiency

Keywords

• severe acute pancreatitis
• blood purification
• long-term efficacy
• cost-efficiency