阿司匹林降低了与败血症相关的急性损伤的死亡风险:使用MIMIC IV数据库的观察性研究
Sining Chen1, Shishi Li1, Chaoying Kuang1
1Nephrology Department, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, China.
Frontiers in pharmacology
|August 10, 2023
概括
与败血症相关的急性损伤 (SA-AKI) 患者的阿司匹林使用与90天死亡率降低和ICU停留时间缩短有关. 这项研究发现,在SA-AKI患者中,阿司匹林治疗没有增加胃肠道出血的风险.
科学领域:
- 腎病學和重症醫療醫學 腎病學和重症醫學
- 药理学和治疗学 药理学和治疗学
背景情况:
- 败血症相关的急性损伤 (SA-AKI) 是一个重大的临床挑战,死亡率高.
- 阿司匹林的抗炎和抗血小板特性表明在败血症中具有潜在的益处,但关于SA-AKI结果的证据仍然矛盾.
研究的目的:
- 在SA-AKI中调查阿司匹林利用与患者结局之间的关联.
- 评估阿司匹林对SA-AKI患者死亡率,ICU停留时间和胃肠道出血风险的影响.
主要方法:
- 从MIMIC-IV数据库中对12,091名SA-AKI患者进行了回顾性分析.
- 倾向性得分匹配用于平衡阿司匹林使用者和非使用者之间的基线特征.
- 使用卡普兰-梅尔分析和多变量考克斯比例危险回归模型来评估死亡风险.
主要成果:
- 在7694名患者的匹配队列中,阿司匹林使用与90天死亡率显著降低有关 (调整HR:0.722).
- 与非使用者相比,阿司匹林使用者表现出更高的90天生存率和更长的中位生存时间.
- 阿司匹林使用与平均ICU停留时间缩短相关,并且胃肠道出血风险没有显著增加.
结论:
- 阿司匹林治疗可能会降低SA-AKI患者的30天和90天死亡风险.
- 阿司匹林的使用与SA-AKI患者的急症监护室停留时间缩短有关.
- 该研究没有发现在这种患者群体中,阿司匹林对胃肠道出血的风险增加具有统计学意义.
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