Terminal complement inhibition is associated with renal, hematologic, and thrombotic complications during septic shock: A global propensity score-matched cohort study
Authors' conclusion
In septic shock, terminal complement inhibition was associated with increased renal, hematologic, and thrombotic complications without a significant difference in short-term mortality.
Study context
- Population
- Adults with septic shock and an underlying indication for C5 inhibition (atypical hemolytic uremic syndrome, myasthenia gravis, neuromyelitis optica spectrum disorder, or paroxysmal nocturnal hemoglobinuria)propensity score-matched
- Participants
- 638 vs 638
- Exposure
- Terminal complement inhibition vs none
- Complement inhibitionn = 638
- No complement inhibitionn = 638reference
- Outcome
- Clinical outcomes (complications)
- Follow-up
- 31 days
Methodological detailspropensity score-matched, TriNetX Global Collaborative Network (federated EHR data)
- Propensity score-matched
- TriNetX Global Collaborative Network (federated EHR data)
Main finding
As reported in the abstract
- Thrombocytopenia: 20.3% vs 8.9%
- p < 0.001
- AKI: 25.0% vs 13.3%
- p < 0.001
- Thrombotic disorders: 7.8% vs 4.7%
- p = 0.021
- RRT: 8.3% vs 5.1%
- p = 0.026
- MACE: 13.7% vs 9.2%
- p = 0.011
Observational data: associations, not effects.
Further findings
Thirty-day mortality · 30 days
- Did not differ between the matched cohorts
Overall outcome pattern (7-day sensitivity analysis)
- Remained consistent
Original publication
Terminal complement inhibition is associated with renal, hematologic, and thrombotic complications during septic shock: A global propensity score-matched cohort study. J Crit Care. Published 29 July 2026. doi:10.
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