Clinical efficacy of continuous blood purification (CBP) in the treatment of severe acute pancreatitis with multiple organ dysfunction syndrome (MODS): A retrospective study

Abstract

This study aims to evaluate the efficacy of continuous blood purification (CBP) in patients with severe acute pancreatitis (SAP) complicated by multiple organ dysfunction syndrome (MODS). The study analyzes the impact of CBP on organ function, inflammatory markers, length of hospital stay, and mortality. A total of 200 hospitalized patients who met the diagnostic criteria for SAP and MODS were included in this study. They were divided into the experimental group (CBP treatment group, n = 92) and the control group (standard treatment group, n = 108). The experimental group received CBP treatment, while the control group received standard medical supportive care. Propensity score matching was used to ensure baseline comparability between the 2 groups. Various statistical methods, including survival analysis and mediation effect analysis, were employed to assess the efficacy of CBP. At 24 hours posttreatment, the sequential organ failure assessment score was 7.5 ± 2.1 in the experimental group and 8.3 ± 2.4 in the control group (P = .02). At 72 hours and 7 days posttreatment, the sequential organ failure assessment scores in the experimental group were significantly lower than those in the control group (P < .001). Regarding inflammatory markers, C-reactive protein levels were 98.4 ± 37.5 mg/L in the experimental group compared to 110.5 ± 40.8 mg/L in the control group (P = .03). Interleukin-6 decreased to 42.6 ± 16.3 pg/mL in the experimental group, whereas it was 48.9 ± 19.2 pg/mL in the control group (P = .01). Tumor necrosis factor-α levels posttreatment were 52.4 ± 18.7 pg/mL in the experimental group and 67.1 ± 23.5 pg/mL in the control group (P = .002). The length of hospital stay was 22.7 ± 6.9 days in the experimental group and 20.8 ± 6.4 days in the control group (P = .02). The mortality rate was 15.3% in the experimental group and 26.4% in the control group (P = .04). The Kaplan-Meier survival curve analysis indicated that the survival rate in the experimental group was higher than in the control group (P = .021). CBP treatment significantly reduces systemic inflammatory responses, improves organ function, and lowers mortality in patients with SAP and MODS. Further studies are needed to optimize anticoagulation strategies in CBP to improve outcomes while minimizing the risk of complications.

Keywords: continuous blood purification; inflammatory markers; multiple organ dysfunction syndrome; severe acute pancreatitis; survival rate.

Figure 1.

K-M survival curve between the 2 groups. CBP = continuous blood purification, K-M = Kaplan–Meier.