MIMIC-IV 数据库中重症监护病房前阿司匹林用药与 ARDS 死亡率之间的关系:一项队列研究。

IF 3.3 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Yi Yu , Dengcan Yang , Qianqian Wang , Jian Li
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引用次数: 0

摘要

背景:急性呼吸窘迫综合征(ARDS)是一种严重的疾病,死亡率和发病率都很高。有关药物干预对 ARDS 治疗效果的证据十分有限。最近的研究表明,阿司匹林可预防 ARDS 的发生,但其对已确诊 ARDS 的疗效尚不确定:我们利用重症监护医学信息市场-IV(MIMIC-IV)数据库的数据招募了 ARDS 患者。主要结果是 30 天和 90 天的死亡率以及重症监护病房的住院时间。我们采用多变量考克斯回归和线性回归模型进行统计分析,并使用倾向得分匹配(PSM)来确保结果的稳健性:研究共纳入 10,042 名参与者,平均年龄为 61.8 ± 15.3 岁。Kaplan-Meier 分析显示,与未服用阿司匹林的患者相比,ICU 入院前服用阿司匹林的患者的 30 天和 90 天死亡率明显降低(p 结论:我们的研究结果表明,ICU 入院前服用阿司匹林的患者的 30 天和 90 天死亡率明显降低:我们的研究结果表明,ICU 入院前服用阿司匹林可显著降低 ARDS 患者 30 天和 90 天的死亡率,并缩短 ICU 的住院时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between pre-ICU aspirin administration and ARDS mortality in the MIMIC-IV database: A cohort study

Background

Acute Respiratory Distress Syndrome (ARDS) is a severe condition with high mortality and morbidity rates. Evidence on the effectiveness of pharmacological interventions for ARDS treatment is limited. Recent studies suggest that aspirin may prevent ARDS development, but its efficacy in established ARDS is uncertain.

Methods

We enrolled patients with ARDS using data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. Primary outcomes were 30- and 90-day mortality rates and length of ICU stay. We employed multivariable Cox regression and linear regression models for statistical analysis and used propensity score matching (PSM) to ensure robust results.

Results

The study included 10,042 participants with an average age of 61.8 ± 15.3 years. Kaplan–Meier analysis showed significantly lower 30- and 90-day mortality rates in patients treated with pre-ICU admission aspirin compared with non-aspirin use (p < 0.0001). Multivariable Cox regression models revealed a significant 63% reduction in 30-day mortality for pre-ICU aspirin users (HR = 0.37, 95% CI: 0.31–0.44, p < 0.001). Aspirin use in the ICU was associated with a 59% reduction in ICU mortality and a 0.68-day reduction in length of ICU stay (p < 0.05). These findings consistently indicate that aspirin may improve survival in patients with ARDS, even after further stratification of aspirin use and PSM analysis.

Conclusion

Our findings suggest that aspirin treatment before ICU admission is associated with significantly reduced 30- and 90-day mortality rates and decreased length of ICU stay in patients with ARDS.

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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
41
审稿时长
42 days
期刊介绍: Pulmonary Pharmacology and Therapeutics (formerly Pulmonary Pharmacology) is concerned with lung pharmacology from molecular to clinical aspects. The subject matter encompasses the major diseases of the lung including asthma, cystic fibrosis, pulmonary circulation, ARDS, carcinoma, bronchitis, emphysema and drug delivery. Laboratory and clinical research on man and animals will be considered including studies related to chemotherapy of cancer, tuberculosis and infection. In addition to original research papers the journal will include review articles and book reviews. Research Areas Include: • All major diseases of the lung • Physiology • Pathology • Drug delivery • Metabolism • Pulmonary Toxicology.
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