Impact of Angiotensin Receptor Blockers Use on In-Hospital Mortality in Community-Acquired Pneumonia Patients with Hypertension.

IF 3.2 4区医学 Q1 UROLOGY & NEPHROLOGY

Kidney Diseases Pub Date : 2023-06-14 eCollection Date: 2023-10-01 DOI:10.1159/000531479

Dawei Chen, Yan Tan, Xin Wan

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Abstract

Introduction: This study aimed to explore the association of angiotensin receptor blockers (ARBs) use with in-hospital mortality among Chinese patients with hypertension hospitalized with community-acquired pneumonia (CAP).

Methods: This study was conducted from January 2014 to January 2017, and data from patients with hypertension hospitalized with CAP were analyzed retrospectively. Multivariable logistic regression and propensity score matching (PSM) were used to investigate any association.

Results: 1,510 patients were included in this study. The crude in-hospital mortality was significantly lower in patients with ARBs use (4.2% vs. 12.5%, p < 0.001). In the extended multivariable logistic models, the odds ratios (ORs) of ARBs use were consistently significant in all six models (OR range 0.27-0.48, p < 0.05 for all). After subgroup analysis, ARBs use remained a potentially protective factor against in-hospital mortality, and no interaction was detected. After PSM, the in-hospital mortality remained significantly lower in the ARBs use group (4.2% vs. 10.9%, p = 0.002). In the univariate analysis, using ARBs was associated with in-hospital mortality (PSM OR, 0.36; 95% CI, 0.19-0.68; p = 0.002). Additionally, compared with the control group, ARBs use did not significantly increase the risk of acute kidney injury (12.4% vs. 10.9%, p = 0.628), renal replacement therapy (0.6% vs. 0.3%, p = 1.000), and hyperkalemia (1.8% vs. 2.1%, p = 1.000).

Conclusion: Although residual confounding cannot be excluded, the use of ARBs was associated with lower in-hospital mortality in Chinese patients with hypertension hospitalized with CAP.

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血管紧张素受体阻滞剂对社区获得性肺炎合并高血压患者住院死亡率的影响。

引言：本研究旨在探讨因社区获得性肺炎（CAP）住院的中国高血压患者使用血管紧张素受体阻滞剂（ARBs）与住院死亡率的关系。方法：本研究于2014年1月至2017年1月进行，对因CAP住院的高血压患者的数据进行回顾性分析。使用多变量逻辑回归和倾向评分匹配（PSM）来研究任何关联。结果：1510例患者被纳入本研究。使用ARBs的患者的粗住院死亡率显著降低（4.2%对12.5%，p＜0.001）。在扩展的多变量逻辑模型中，所有六个模型中使用ARBs的比值比（OR）始终显著（OR范围0.27-0.48，p＜0.05）。经过亚组分析，ARBs的使用仍然是预防住院死亡率的潜在保护因素，并且没有检测到相互作用。PSM后，ARBs使用组的住院死亡率仍然显著较低（4.2%vs.10.9%，p=0.002）。在单变量分析中，使用ARBs与住院死亡率相关（PSM OR，0.36；95%CI，0.19-0.68；p=0.002），此外，与对照组相比，使用ARRs并没有显著增加急性肾损伤的风险（12.4%vs.109%，p=0.028），肾替代治疗（0.6%对0.3%，p=0.000）和高钾血症（1.8%对2.1%，p=0.000。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney Diseases UROLOGY & NEPHROLOGY-

CiteScore

6.00

自引率

2.70%

发文量

审稿时长

27 weeks

期刊介绍： ''Kidney Diseases'' aims to provide a platform for Asian and Western research to further and support communication and exchange of knowledge. Review articles cover the most recent clinical and basic science relevant to the entire field of nephrological disorders, including glomerular diseases, acute and chronic kidney injury, tubulo-interstitial disease, hypertension and metabolism-related disorders, end-stage renal disease, and genetic kidney disease. Special articles are prepared by two authors, one from East and one from West, which compare genetics, epidemiology, diagnosis methods, and treatment options of a disease.