From the Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.
Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
QJM. 2019 Apr 1;112(4):253-259. doi: 10.1093/qjmed/hcy278.
The influence of red yeast rice (RYR) on perioperative outcome remains unknown.
We aimed to compare the complications and mortality after surgery between patients treated with and without RYR prescription.
In this surgical cohort study of 3.6 million surgical patients who underwent major inpatient surgeries, 2581 patients who used RYR prescription pre-operatively were compared with 25 810 non-RYR patients selected by matching for age and sex.
Patients' demographics and medical conditions were collected from the claims data of the National Health Insurance in Taiwan. Complications and mortality after major surgeries in association with RYR prescription were investigated by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) by multiple logistic regression.
Compared with patients without RYR prescription, patients prescribed RYR had lower risks of post-operative bleeding (OR 0.36, 95% CI 0.15-0.89), pneumonia (OR 0.54, 95% CI 0.36-0.83), stroke (OR 0.66, 95% CI 0.47-0.92) and 30-day in-hospital mortality (OR 0.37, 95% CI 0.15-0.92). Decreased risk of intensive care (OR 0.64, 95% CI 0.54-0.77), shorter length of hospital stay (P < 0.001) and lower medical expenditures (P = 0.0008) during the index surgical admission were also noted for patients with RYR prescription compared to those for patients without RYR prescription.
This study showed a potentially positive effect of RYR on outcomes after major surgeries. However, patient non-compliance for taking medication should be noted. Our findings require future prospective studies to validate RYR prescription for improving perioperative outcomes.
红曲米（RYR）对围手术期结局的影响尚不清楚。
我们旨在比较服用和未服用 RYR 处方的患者手术后的并发症和死亡率。
在这项针对 360 万例接受主要住院手术的手术患者的外科队列研究中，将 2581 例术前使用 RYR 处方的患者与通过年龄和性别匹配选择的 25810 例非 RYR 患者进行比较。
从台湾全民健康保险的理赔数据中收集患者的人口统计学和医疗状况。通过多因素逻辑回归计算调整后的比值比（OR）和 95％置信区间（CI），调查与 RYR 处方相关的主要手术后并发症和死亡率。
与未服用 RYR 处方的患者相比，服用 RYR 的患者术后出血（OR 0.36，95％CI 0.15-0.89）、肺炎（OR 0.54，95％CI 0.36-0.83）、中风（OR 0.66，95％CI 0.47-0.92）和 30 天住院内死亡率（OR 0.37，95％CI 0.15-0.92）的风险较低。与未服用 RYR 处方的患者相比，服用 RYR 的患者入住重症监护病房（OR 0.64，95％CI 0.54-0.77）的风险较低、住院时间较短（P <0.001）且医疗支出较低（P = 0.0008）。
本研究表明 RYR 对主要手术后的结果可能有积极影响。但是，应该注意到患者不遵守服药的情况。我们的发现需要未来的前瞻性研究来验证 RYR 处方是否可以改善围手术期结局。
