Department of Anesthesiology, Pidu District People's Hospital, Chengdu & The Third affiliated Hospital of Chengdu Medical College, Chengdu, PR, China.
Biotechnol Genet Eng Rev. 2024 Apr;40(1):562-575. doi: 10.1080/02648725.2023.2186309. Epub 2023 Mar 9.
Sedative and analgesic drugs are commonly used in the diagnosis and treatment of cancer patients. Analyzing the impact of these drugs on the prognosis of cancer patients can help improve patient outcomes. This study aimed to analyze the use of propofol, benzodiazepines, and opioids on the survival of cancer patients in the intensive care unit (ICU) based on the Medical Information Mart for Intensive Care III (MIMIC-III) database. A total of 2,567 cancer patients from the MIMIC-III database between 2001 and 2012 were included in this retrospective cohort study. Logistic regression analyses were utilized to assess the relationship between propofol, benzodiazepine, and opioid and survival in cancer patients. The follow-up was 1 year from the patient's first admission to the ICU. Outcomes were ICU mortality, 28-day mortality, and 1-year mortality. Stratified analyses were based on patients' metastatic status. The use of propofol [odds ratio (OR) = 0.66; 95% confidence interval (CI), 0.53-0.80] and opioids (OR = 0.65; 95%CI, 0.54-0.79) were associated with a decreased risk of 1-year mortality. Both benzodiazepines and opioids use were related to an increased risk of ICU mortality and 28-day mortality (all < 0.05), whereas propofol use was associated with a decreased risk of 28-day mortality (OR = 0.59; 95%CI, 0.45-0.78). Compared with the use of benzodiazepines combined with opioids, patients who used propofol and opioids were related to a decreased risk of 1-year mortality (OR = 0.74; 95%CI, 0.55-0.98). Similar results were found in patients with metastasis and metastasis-free. Cancer patients who used propofol may experience a lower risk of mortality than benzodiazepine use.
镇静和镇痛药物常用于癌症患者的诊断和治疗。分析这些药物对癌症患者预后的影响有助于改善患者的结局。本研究旨在基于医疗信息互操作资源库 III（MIMIC-III）数据库，分析丙泊酚、苯二氮䓬类药物和阿片类药物对重症监护病房（ICU）癌症患者生存的影响。本回顾性队列研究纳入了 2001 年至 2012 年 MIMIC-III 数据库中 2567 例癌症患者。采用 logistic 回归分析评估丙泊酚、苯二氮䓬类药物和阿片类药物与癌症患者生存的关系。随访时间为患者入住 ICU 后的 1 年。结局为 ICU 死亡率、28 天死亡率和 1 年死亡率。分层分析基于患者的转移状态。丙泊酚（比值比[OR] = 0.66；95%置信区间[CI]，0.53-0.80）和阿片类药物（OR = 0.65；95%CI，0.54-0.79）的使用与 1 年死亡率降低相关。苯二氮䓬类药物和阿片类药物的使用均与 ICU 死亡率和 28 天死亡率升高相关（均<0.05），而丙泊酚的使用与 28 天死亡率降低相关（OR = 0.59；95%CI，0.45-0.78）。与使用苯二氮䓬类药物联合阿片类药物相比，使用丙泊酚和阿片类药物的患者 1 年死亡率降低（OR = 0.74；95%CI，0.55-0.98）。在有转移和无转移的患者中也发现了类似的结果。与使用苯二氮䓬类药物相比，使用丙泊酚的癌症患者的死亡率可能较低。
