Vasopressor Therapy for Patients Suffering from Septic Shock Does Not Increase the Risk of In-Hospital Amputation. A Ret-rospective Analysis of 4,468 Patients Demonstrating the Need for Personalized Therapy

Background. The use of vasoconstricting agents is an important part of the armament used by modern medicine in the treatment of patients suffering from septic shock. Nevertheless, their administration is associated with different severities of limb ischemia. The aim of the current study was to quantify this adverse outcome of treatment. Methods. This retrospective study analyzed patients suffering from septic shock, who were hospitalized in a tertiary medical center. Results. Out of 7,160 patients suffering from septic shock that were hospitalized in our medical center over a period of 13 years, 4,468 were eligible for analysis. Among them 2,181 received vasopressor treatment, and 2,287 did not. While the rate of in-hospital mortality was higher in the vasopressor group (32.3% vs. 27.4%; p < 0.001), as was the incidence of acute kidney injury (28.1% vs. 18.4%; p < 0.001) and the portion of patients with in-hospital length of stay > 7 days (65.4% vs. 61.5%; p = 0.007), there was no significant difference between the rate of in-hospital amputations between the two study groups (0.8% vs. 1.1%; p = 0.44). Independent risk factors for amputations include older age and preexisting diagnosis of peripheral vascular disease.. Conclusion. The use of vasopressors as part of the treatment for patients suffering from septic shock does not appear to increase the risk of resultant amputations. Nevertheless, advanced age and pre-morbid peripheral vascular disease are associated with a higher likelihood of amputation.