| アブストラクト | BACKGROUND: Secondary pulmonary hemorrhage increases the risk of mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV); plasma exchange therapy may improve outcomes in these patients. We conducted a retrospective cohort study to investigate the effect of plasma exchange therapy on short-term prognoses in patients with pulmonary hemorrhage secondary to AAV. METHODS: This study utilized the Diagnosis Procedure Combination database, which is a nationwide inpatient database in Japan. We checked the abstract data and medical actions and identified the patients with pulmonary hemorrhage secondary to AAV who required proactive treatment between 2009 and 2014. To compare the in-hospital mortality, we performed propensity score matching between the plasma exchange and non-plasma exchange groups at a ratio of 1:1. RESULTS: Of the 52,932 patients with AAV, 940 developed pulmonary hemorrhage as a complication. A total of 249 patients from 194 hospitals were eligible for the study. Propensity score matching at a ratio of 1:1 was performed, and 59 pairs were formed (plasma exchange group, n = 59; non-plasma exchange group, n = 59). A statistically significant difference was found in the all-cause in-hospital mortality between the plasma exchange and non-plasma exchange groups (35.6% vs. 54.2%; p = 0041; risk difference, -18.6; 95% confidence interval (CI), -35.4% to -0.67%). CONCLUSION: Thus, plasma exchange therapy was associated with improved in-hospital mortality in patients with pulmonary hemorrhage secondary to AAV. |
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| ジャーナル名 | PloS one |
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| 投稿日 | 2018/04/24 |
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| 投稿者 | Uechi, Eishi; Okada, Masato; Fushimi, Kiyohide |
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| 組織名 | Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School, Yushima, Bunkyo-ku, Tokyo, Japan.;Division of Rheumatology, Tomishiro Central Hospital, Ueta, Tomigusuku-shi,;Okinawa, Japan.;Immuno-Rheumatology Center, St. Luke's International Hospital, St. Luke's;International University, Akashi-cho Chuo-Ku, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/29684034/ |
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