Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, 1129 Nagaoka, Izunokuni City, Shizuoka, 410-2295, Japan.
Sci Rep. 2022 Jul 26;12(1):12737. doi: 10.1038/s41598-022-17182-3.
Although the regular administration of antihypertensive drugs is a risk factor for falls in older adults, whether their anti-inflammatory effects confer a survival benefit in older adults remains unknown. This single-center retrospective cohort study examined patients with trauma aged ≥ 65 admitted to our hospital between January 2018 and December 2020. Patients who had not received antihypertensive drugs before admission (i.e., AHT(-) group) and those who had received the drugs (i.e., AHT(+) group) were compared using a 1:1 propensity score-matched analysis. The primary outcome was 28-day mortality, and the secondary outcomes were in-hospital mortality and the incidence of complications during the hospital stay. In total, 637 patients were analyzed. After propensity score matching, each study group had 223 patients. No significant difference was observed in the primary outcome (28-day mortality: AHT(-) group, 3.6% vs. AHT(+) group, 3.6%; adjusted relative risk: 1.00, 95% confidence interval (CI): 0.38-2.62); only the in-hospital incidence of delirium was significantly low in the AHT(+) group (25.1% vs. 13.9%; adjusted relative risk: 0.55, 95% CI: 0.37-0.82). Overall, the regular use of antihypertensive drugs did not affect outcomes in geriatric trauma patients; however, the incidence of delirium was reduced in those regularly receiving antihypertensive drugs.
尽管定期服用降压药是老年人跌倒的一个风险因素，但它们的抗炎作用是否能给老年人带来生存获益尚不清楚。这项单中心回顾性队列研究纳入了 2018 年 1 月至 2020 年 12 月期间我院收治的≥65 岁创伤患者。比较了入院前未接受降压药治疗的患者（即 AHT(-)组）和接受降压药治疗的患者（即 AHT(+)组），采用 1:1 倾向评分匹配分析。主要结局是 28 天死亡率，次要结局是院内死亡率和住院期间并发症的发生率。共分析了 637 例患者。经倾向评分匹配后，每组各有 223 例患者。主要结局（28 天死亡率：AHT(-)组为 3.6%，AHT(+)组为 3.6%；调整后的相对风险：1.00，95%置信区间[CI]：0.38-2.62）无显著差异；仅 AHT(+)组院内谵妄发生率显著降低（25.1% vs. 13.9%；调整后的相对风险：0.55，95%CI：0.37-0.82）。总体而言，降压药的常规使用并未影响老年创伤患者的结局；然而，定期服用降压药可降低谵妄的发生率。
