A real-world study for safety evaluation and risk assessment of disposable hemoperfusion devices

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Author: LI Kaili ^1# FU Yuanfeng ^2# ZENG Baoqi ^1, ^3, ⁴  ZHANG Yunxian ²  SUN Feng ^1, ^3, ^5, ^6, ⁷

Affiliation: 1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China 2. Guangdong Provincial Center for Drug Adverse Reaction Monitoring, Guangzhou 510080, China 3. Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China 4. Central Laboratory, Tianjin Fiﬅh Central Hospital (Binhai Hospital of Peking University), Tianjin 300450, China 5. Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China 6. School of Traditional Chinese Medicine, Xinjiang Medical University, Urumqi 830017, China 7. School of Medicine, Shihezi University, Shihezi 832000, Xinjiang Uygur Autonomous Region, China

Keywords: Disposable hemoperfusion devices Adverse events Hypotension Hemoperfusion occlusion Influencing factors

DOI: 10.12173/j.issn.1005-0698.202506008

Reference: LI Kaili, FU Yuanfeng, ZENG Baoqi, ZHANG Yunxian, SUN Feng. A real-world study for safety evaluation and risk assessment of disposable hemoperfusion devices[J]. Yaowu Liuxingbingxue Zazhi, 2025, 34(10): 1159-1168. DOI: 10.12173/j.issn.1005-0698.202506008.[Article in Chinese]  Copied

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Abstract

Objective To analyze the characteristics of adverse events of disposable hemoperfusion devices in real-world clinical practice using multicenter data, and to investigate the influencing factors of hypotension, providing evidence for the safe clinical use of these devices.

Methods An observational study was conducted involving patients who received disposable hemoperfusion therapy across 17 sentinel hospitals in China from June 2022 to July 2024. Device-related adverse events were monitored and analyzed. Descriptive statistics, Firth's Logistic regression model, and balanced random forest model were applied to systematically evaluate the manifestations of adverse events and the risk factors for the occurrence of hypotension.

Results A total of 17,824 usage records were included. In the sentinel hospital data, hypotension [0.19%, 95%CI (0.14%, 0.27%)] and hemoperfusion occlusion [0.13%, 95%CI (0.09%, 0.19%)] occupied the highest incidence rate. The Firth's Logistic regression analysis revealed that end-stage renal disease with comorbidities significantly increased hypotension risk (OR=77.324), while no prior medical history was protective (OR=0.061). Stepwise blood purification modalities (hemoperfusion alone or sequential hemoperfusion-hemodialysis) significantly reduced the hypotension risk compared with simultaneous hemoperfusion and hemodialysis (OR=0.003). The random forest model further confirmed that blood purification modality was the strongest influencing factor for hypotension.

Conclusion In real-world clinical settings, hypotension and device occlusion were the predominant adverse events, with blood purification modality critically influencing hypotension risk. Stepwise blood purification is recommended to mitigate this risk. Enhancing clinical operating procedures and device design is essential to improve overall treatment safety.

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References

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