Department of Clinical Pharmacology and Therapeutics, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
Department of Emergency Pharmaceutical Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 1-1-1 Tsushima-naka, Okayama, 700-8530, Japan.
Sci Rep. 2017 Dec 20;7(1):17919. doi: 10.1038/s41598-017-17686-3.
There are few reports on hydrocortisone administration after cardiac arrest, and those that have been published included few subjects. This study aimed to evaluate the effect of hydrocortisone administration on the outcomes of patients who experienced cardiac arrest. We investigated the survival discharge rates and the length of hospital stay from cardiac arrest to discharge, stratified by use of hydrocortisone, using a Japanese health-insurance claims dataset that covers approximately 2% of the Japanese population. The study included the data of 2233 subjects who experienced either in-hospital or out-of-hospital cardiac arrest between January 2005 and May 2014. These patients were divided into two groups, based on the administration of hydrocortisone. We adjusted the baseline characteristics, medical treatment, and drug administration data of the two groups using propensity scores obtained via the inverse probability of treatment weighted method. The hydrocortisone group had a significantly higher survival discharge rate (13/61 [21.1%] vs. 240/2172 [11.0%], adjusted odds ratio: 4.2, 95% CI: 1.60-10.98, p = 0.004). In addition, the administration of hydrocortisone was independent predictor of survival to discharge (hazard ratio: 4.6, p < 0.001). The results demonstrate a correlation between hydrocortisone administration and the high rates of survival to discharge.
关于心脏骤停后给予氢化可的松的报道很少，已发表的研究报告中纳入的病例也很少。本研究旨在评估心脏骤停患者应用氢化可的松对其预后的影响。我们利用涵盖约 2%日本人口的医疗保险索赔数据集，调查了心脏骤停后出院时的生存率和住院时间，按氢化可的松的使用情况进行分层。研究纳入了 2005 年 1 月至 2014 年 5 月期间发生院内或院外心脏骤停的 2233 例患者的数据。这些患者根据是否应用氢化可的松分为两组。我们通过逆概率治疗加权法获得的倾向评分，对两组的基线特征、医疗和药物治疗数据进行了调整。氢化可的松组的生存率出院率明显更高（13/61 [21.1%] vs. 240/2172 [11.0%]，调整后的优势比：4.2，95%CI：1.60-10.98，p = 0.004）。此外，氢化可的松的应用是生存至出院的独立预测因素（风险比：4.6，p < 0.001）。结果表明氢化可的松的应用与高生存率出院率相关。
