Zhang Min, Jian Lijuan, Min Xinping, Li Bowen, Cai Xin, Wang Zhiwei, Hu Zhipeng
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China.
J Cardiovasc Dev Dis. 2022 May 28;9(6):173. doi: 10.3390/jcdd9060173.
Background: Former studies have revealed that fluoroquinolone (FQ) can induce aortic expansion and rupture. While FQ is widely used in perioperative anti-infection therapy, its impact on graft patency and patient survival is unknown. Methods: Coronary artery bypass grafting (CABG) data were extracted from the MIMIC-III database. Chi-square tests, Fisher’s exact tests, t-tests, or ANOVAs were used to compare baseline data between groups determined by FQ therapy status, depending on the data type. Propensity score matching was used to establish a balanced cohort. Cox regression was used to investigate the impact of FQ on CABG patient survival, whereas paired t-tests were used to analyze secondary results. Results: Of the 5030 patients who underwent CABG, 937 (18.6%) received oral or intravenous FQ therapy. Using propensity score matching, these 819 patients were successfully matched with 819 controls in a 1:1 ratio. Cox regression showed that FQ significantly decreased survival among CABG patients (HR: 1.62, 95% CI: 1.21−2.15, p = 0.001). Furthermore, FQ usage was associated with longer hospitalization (<0.0001), ICU duration (<0.0001), ventilation period (<0.0001), and duration of vasopressor administration (<0.0001). Conclusions: Perioperative FQ therapy was associated with worse prognosis and a more difficult recovery among patients with CABG.
既往研究表明，氟喹诺酮（FQ）可导致主动脉扩张和破裂。虽然FQ广泛用于围手术期抗感染治疗，但其对移植物通畅率和患者生存率的影响尚不清楚。方法：从MIMIC-III数据库中提取冠状动脉旁路移植术（CABG）数据。根据数据类型，采用卡方检验、Fisher精确检验、t检验或方差分析来比较由FQ治疗状态确定的组间基线数据。使用倾向评分匹配来建立一个平衡队列。采用Cox回归研究FQ对CABG患者生存的影响，而采用配对t检验分析次要结果。结果：在5030例行CABG的患者中，937例（18.6%）接受了口服或静脉FQ治疗。通过倾向评分匹配，这819例患者成功地与819例对照以1:1的比例进行了匹配。Cox回归显示，FQ显著降低了CABG患者的生存率（HR：1.62，95%CI：1.21−2.15，p = 0.001）。此外，使用FQ与更长的住院时间（<0.0001）、ICU住院时间（<0.0001）、通气时间（<0.0001）和血管升压药使用时间（<0.0001）相关。结论：围手术期FQ治疗与CABG患者预后较差和恢复较困难有关。
