Lee Cynthia Wei-Sheng, Chen Hsuan-Ju, Liang Ji-An, Kao Chia-Hung
Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan.
Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung, Taiwan.
BMJ Open. 2017 Jan 16;7(1):e013761. doi: 10.1136/bmjopen-2016-013761.
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, and sepsis is a frequent cause of death in hospitalised patients. We investigated the relationship between ALS and the subsequent risk of sepsis.
A retrospective cohort analysis.
Patients with ALSs diagnosed between 2000 and 2010 in Taiwan National Health Insurance Research Database.
We included 701 and 2804 patients as the ALS and the non-ALS groups, respectively.
The risk of sepsis was calculated by Cox proportional hazards regression model.
During the follow-up period, the incidence density rates were 77.8 and 11.1 per 1000 person-years in the ALS and non-ALS groups, respectively. After adjusting for sex, age, Charlson comorbidity index score, life-support measures, and β-adrenoceptor agonists treatment, the ALS group had a higher risk of sepsis (HR=3.42; 95% CI 2.60 to 4.50) than the non-ALS group. An increase of the risk was observed in patients with ALS receiving life support treatment measures, whereas a decrease of the risk was associated with treatment of β-adrenoceptor agonists.
The risk of sepsis is associated with a prior ALS diagnosis, and may be increased by the use of life support measures and decreased by β-adrenoceptor agonists.
肌萎缩侧索硬化症（ALS）是一种致命的神经退行性疾病，脓毒症是住院患者常见的死亡原因。我们研究了ALS与随后发生脓毒症风险之间的关系。
一项回顾性队列分析。
台湾国民健康保险研究数据库中2000年至2010年间诊断为ALS的患者。
我们分别纳入了701例和2804例患者作为ALS组和非ALS组。
采用Cox比例风险回归模型计算脓毒症风险。
在随访期间，ALS组和非ALS组的发病密度率分别为每1000人年77.8例和11.1例。在调整性别、年龄、Charlson合并症指数评分、生命支持措施和β-肾上腺素能受体激动剂治疗后，ALS组发生脓毒症的风险高于非ALS组（HR = 3.42；95%CI 2.60至4.50）。接受生命支持治疗措施的ALS患者风险增加，而β-肾上腺素能受体激动剂治疗与风险降低相关。
脓毒症风险与先前诊断的ALS相关，使用生命支持措施可能会增加风险，而β-肾上腺素能受体激动剂可能会降低风险。
