Prognostic death factors in secondary hemophagocytic lymphohistiocytosis children with multiple organ dysfunction syndrome receiving continuous renal replacement therapy: A multicenter prospective nested case-control study

Ther Apher Dial. 2022 Oct;26(5):1023-1029. doi: 10.1111/1744-9987.13775. Epub 2021 Dec 22.

Abstract

Introduction: Multiple organ dysfunction syndrome (MODS) with secondary hemophagocytic lymphohistiocytosis (SHLH) causes significant mortality. We aimed to identify the predictor factors for death in pediatric patients with SHLH-associated MODS receiving continuous renal replacement therapy (CRRT).

Methods: This multicentered nested case-control study was conducted from 2016 to 2020. The characteristics were compared between survivors and non-survivors. Logistic regression was applied to identify the risk factors for death. The cutoff values were assessed by receiver operating characteristics curves.

Results: Fifty two patients were enrolled in this study. Interleukin-6 level (p = 0.018) and the number of organ dysfunction (p = 0.047) were independent risk factors for death. The cutoff value of 13.12 pg/ml interleukin-6 and three organs dysfunction at CRRT initiation presented a high sensitivity and specificity.

Conclusion: The number of organ dysfunction and interleukin-6 at CRRT initiation are independent risk factors for death in pediatric patients with SHLH-associated MODS.

Keywords: IL-6; continuous renal replacement therapy; death; pediatric intensive care unit; secondary hemophagocytic lymphohistiocytosis.

Publication types

  • Multicenter Study

MeSH terms

  • Case-Control Studies
  • Child
  • Continuous Renal Replacement Therapy*
  • Humans
  • Interleukin-6
  • Lymphohistiocytosis, Hemophagocytic* / complications
  • Lymphohistiocytosis, Hemophagocytic* / therapy
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / therapy
  • Prognosis
  • Prospective Studies
  • Renal Replacement Therapy / adverse effects
  • Retrospective Studies

Substances

  • IL6 protein, human
  • Interleukin-6