Analysis of the efficacy of direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) according to the prognostic factors in patients with colorectal perforation

作者：Sugimoto Kiichi^*; Sato Koichi; Maekawa Hiroshi; Sakurada Mutsumi; Orita Hajime; Ito Tomoaki; Sakamoto Kazuhiro

来源：Surgery Today, 2013, 43(9): 1031-1038.

DOI：10.1007/s00595-012-0399-y

• Direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP)
• Colorectal perforation
• Prognostic factor
• APACHE II score
• Sepsis

Direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) has been reported to improve the outcomes in patients with colorectal perforation. We retrospectively identified prognostic factors in patients with colorectal perforation and considered the efficacy of PMX-DHP based on these prognostic factors. %26lt;br%26gt;One hundred and fifty-six patients who underwent surgery for colorectal perforation in our department between November 1995 and March 2011 were enrolled in this study. The clinicopathological factors were compared between the survivor and non-survivor groups. %26lt;br%26gt;There were 28 patients (17.9 %) who died within 28 days after surgery. According to the multivariate analysis, an Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 17 or more was a significant independent prognostic factor (P = 0.002, odds ratio = 5.39). There was a significant difference in the survival rates between the patients with APACHE II scores of 16 or less and those with scores of 17 or more who had received the PMX-DHP (+) (P %26lt; 0.0001). %26lt;br%26gt;The APACHE II score is useful as a prognostic factor in patients with colorectal perforation, and the survival rate was 50 % or lower among the patients with APACHE II scores of 17 or higher. Therefore, PMX-DHP appears to have limited efficacy in serious cases.

• 出版日期2013-9