Prediktori vremenski zavisnog preživljavanja kod bolesnika sa septičkim šokom liječenih ekstrakorporalnim pročišćavanjem krvi: parametrijska analiza preživljavanja
Sažetak
Background: Sepsisremains associatewith high mortality despite advances in organ support, including extracorporeal blood purification. Conventional prognostic tools rely on static endpoints and do not capture dynamic mortality risk. We aimed to identify predictors of time-dependent survival in sepsis patients.
Methods: We conducted a retrospective, single-center study of adults with sepsis or septic shock treated with continuous renal replacement therapy incorporating CytoSorb® or oXiris®. Demographic, clinical, and laboratory data were extracted. Survival was analyzed using Kaplan–Meier estimates, Cox proportional hazards regression, and parametric survival models. Multivariable analyses estimated independent effects, and the final parametric model was used to derive survival probabilities and median survival times conditional on covariates.
Results: Among 94 patients, 42 deaths occurred. In multivariable Cox analysis, higher D-dimer, lactate (Lact), and SAPS II were independent predictors: each 10 µg/mL increase in D-dimer was associated with a 15% higher hazard, each 1 mmol/L increase in Lactwith 12%, and each 1-point increase in SAPS II with 3% higher hazard. The log-normal parametric model confirmed these predictors were associated with shorter expected survival.
Conclusions: D-dimer, lactate, and SAPS II independently predict mortality in ICU patients with sepsis or septic shock undergoing extracorporeal blood purification. These findings provide a dynamic, quantitative framework for risk stratification and clinical decision-making. Prospective multicenter studies are needed to validate these results.
Sva prava zadržana (c) 2026 Danica Momcicevic, Katarina Vucicevic, Nikolina Spiric, Biljana Zlojutro, Milka Jandric, Sasa Dragic, Nikola Sobot, Tijana Kovacevic, Peđa Kovačević
Ovaj rad je pod Creative Commons Autorstvo 4.0 međunarodnom licencom.
The published articles will be distributed under the Creative Commons Attribution 4.0 International License (CC BY). It is allowed to copy and redistribute the material in any medium or format, and remix, transform, and build upon it for any purpose, even commercially, as long as appropriate credit is given to the original author(s), a link to the license is provided and it is indicated if changes were made. Users are required to provide full bibliographic description of the original publication (authors, article title, journal title, volume, issue, pages), as well as its DOI code. In electronic publishing, users are also required to link the content with both the original article published in Journal of Medical Biochemistry and the licence used.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.