PMID- 29684034
OWN - NLM
STAT- MEDLINE
DCOM- 20180720
LR  - 20181114
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 4
DP  - 2018
TI  - Effect of plasma exchange on in-hospital mortality in patients with pulmonary 
      hemorrhage secondary to antineutrophil cytoplasmic antibody-associated 
      vasculitis: A propensity-matched analysis using a nationwide administrative 
      database.
PG  - e0196009
LID - 10.1371/journal.pone.0196009 [doi]
LID - e0196009
AB  - 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.
FAU - Uechi, Eishi
AU  - Uechi E
AD  - Department of Health Policy and Informatics, Tokyo Medical and Dental University 
      Graduate School, Yushima, Bunkyo-ku, Tokyo, Japan.
AD  - Division of Rheumatology, Tomishiro Central Hospital, Ueta, Tomigusuku-shi, 
      Okinawa, Japan.
FAU - Okada, Masato
AU  - Okada M
AD  - Immuno-Rheumatology Center, St. Luke's International Hospital, St. Luke's 
      International University, Akashi-cho Chuo-Ku, Tokyo, Japan.
FAU - Fushimi, Kiyohide
AU  - Fushimi K
AUID- ORCID: 0000-0002-1894-0290
AD  - Department of Health Policy and Informatics, Tokyo Medical and Dental University 
      Graduate School, Yushima, Bunkyo-ku, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180423
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*complications
MH  - Female
MH  - Hemorrhage/mortality/*therapy
MH  - *Hospital Mortality
MH  - Humans
MH  - Lung Diseases/mortality/*therapy
MH  - Male
MH  - Plasma Exchange/*methods
MH  - Propensity Score
MH  - Retrospective Studies
MH  - Treatment Outcome
PMC - PMC5912736
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2018/04/24 06:00
MHDA- 2018/07/22 06:00
PMCR- 2018/04/23
CRDT- 2018/04/24 06:00
PHST- 2017/11/15 00:00 [received]
PHST- 2018/04/04 00:00 [accepted]
PHST- 2018/04/24 06:00 [entrez]
PHST- 2018/04/24 06:00 [pubmed]
PHST- 2018/07/22 06:00 [medline]
PHST- 2018/04/23 00:00 [pmc-release]
AID - PONE-D-17-40447 [pii]
AID - 10.1371/journal.pone.0196009 [doi]
PST - epublish
SO  - PLoS One. 2018 Apr 23;13(4):e0196009. doi: 10.1371/journal.pone.0196009. 
      eCollection 2018.