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2018 ; 2018
(ä): 9707932
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Lower In-Hospital Mortality with Plasma Exchange than Plasmapheresis in a
Subgroup Analysis of 374 Lupus Patients
#MMPMID29854814
Su YJ
; Chiu WC
; Hsu CY
; Chen JB
; Ng HY
Biomed Res Int
2018[]; 2018
(ä): 9707932
PMID29854814
show ga
BACKGROUND: Apheresis treatment includes plasmapheresis (PP) and plasma exchange
(PE), and these terms are commonly used interchangeably. Nevertheless, the two
procedures are carried out differently. The aims of this study were to
investigate the mortality rate of patients who underwent therapeutic apheresis
and compare the mortality rate between PP and PE. METHODS: We conducted a medical
chart review retrospective study. All identified subjects (n = 436) were over 20
years old with at least one ICD-9-CM intervention code plasmapheresis or plasma
exchange and at least one diagnosis code with rheumatic disease. All of them were
hospitalized to Chang Gung Memorial Hospital between 1st of January, 2000, and
31st of December, 2014. RESULTS: 436 nonoverlapping patients had never received
PE and/or PP before 1 Jan, 2000. Among all the patients, 350 received PE, 63
received PP, and 23 received both therapies. Female patients accounted for 85.09%
of patients. The overall mortality rate was 4.65% in the PE subgroup, 4.76% with
combination therapy, and 13.46% in the PP subgroup. There were 374 patients
diagnosed as SLE, which is the majority of overall patients who received PE
and/or PE. In multivariate analysis, PE was the sole independent factor predictor
of survival in SLE subgroup patients (p = 0.02, exp(B) = 0.314, 95% CI
0.12-0.81). CONCLUSIONS: We showed that both PP and PE were used in treating a
variety of autoimmune disorders. Plasmapheresis was preferentially carried out in
patients with peripheral neuropathy. In 374 lupus patients treated with either PE
or PP, PE is superior to PP in reducing in-hospital mortality.