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在ICU患者中使用抗血栓药物和风险因素分析,这些患者患有MIMIC-IV下部胃肠道出血
1Department of Gastroenterology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
BMC gastroenterology
|September 18, 2024
概括
在重症监护室 (ICU) 治疗下部胃肠道出血 (LGIB) 患者的抗血栓药物治疗,特别是抗血小板药物,与减少住院死亡率有关. 然而,它可能会增加再次出血的风险和住院时间.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 下胃肠道出血 (LGIB) 是重症监护室 (ICU) 患者的一个重大问题.
- 抗血栓治疗在管理LGIB结局中的作用仍然不完全理解.
研究的目的:
- 评估抗血栓治疗对ICU患者患下部胃肠道出血的结果的影响.
- 评估的关键结果包括住院死亡率,再出血率,住院和重症监护室长度.
主要方法:
- 使用MIMIC-IV 2.2数据库进行的回顾性观察研究.
- 包括513名被诊断患有下部胃肠道出血的ICU患者.
- 统计分析包括多变量考克斯回归和倾向得分匹配.
主要成果:
- 住院死亡率为7.6%,复出出血发生在11.1%的患者中.
- 抗血小板药物的使用独立地与较低的住院死亡风险相关 (HR=0.37).
- 抗凝剂使用与显著更长的住院时间 (17.4天 vs 13.1天) 相关联.
结论:
- 抗血栓治疗,特别是抗血小板治疗,与LGIB的ICU患者的住院死亡率降低有关.
- 虽然对死亡率有好处,但抗血栓剂可能会增加复出出血的风险,并在特定患者群体中延长住院治疗.
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