Polymyxin B Hemoperfusion and Mortality in Abdominal Septic Shock—Reply
- Massimo Antonelli, MDDepartment of Intensive Care and AnesthesiologyCatholic University of Sacred HeartRome, Italy;
- Francesco Giunta, MDDivision of Anesthesiology and Intensive CareUniversity of PisaPisa, Italy;
- Claudio Ronco, MD cronco@goldnet.itDepartment of Nephrology, Dialysis and TransplantationSt Bortolo HospitalVicenza, Italy
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ABDOMEN
- CRITICAL CARE
- DATA INTERPRETATION, STATISTICAL
- DRUG THERAPY
- ENDOTOXINS
- HEMOPERFUSION
- POLYMYXIN B
- SEPSIS
- SHOCK, SEPTIC
In Reply: Dr Vincent and Dr Amaral raise questions about the analytic approach used in our study. An unadjusted description of the data (eg, χ2 analysis) is sufficient if the study goal is to explore the survival of populations. However, if the goal is to investigate the relationship between exposure to a treatment and clinical outcomes, investigators aim to account for confounding factors as well. For EUPHAS, it was appropriate to adjust for the confounding effect of the Sequential Organ Failure Assessment. We used Cox proportional hazard analysis, a valid method used commonly in the literature.1,2
In response to Dr Amaral's comments, we also performed a Fisher exact test. For 28-day mortality, the OR was 0.42 (95% CI, 0.15-1.15; P = .13). Compared with conventional therapy, this estimate is consistent with an 85% decreased risk as well as a 15% increased risk in the polymyxin B group. …
