Yang Rui, Huang Jiasheng, Zhao Yumei, Wang Jia, Niu Dongdong, Ye Enlin, Yue Suru, Hou Xuefei, Cui Lili, Wu Jiayuan
Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Guangdong Engineering Research Center of Collaborative Innovation Technology of Clinical Medical Big Data Cloud Service in Medical Consortium of West Guangdong Province, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.
Front Pharmacol. 2023 Mar 23;14:1162797. doi: 10.3389/fphar.2023.1162797. eCollection 2023.
Thiamine deficiency is common in patients with heart failure, and thiamine supplement can benefit these patients. However, the association between thiamine administration and prognosis among critically ill patients with heart failure remains unclear. Thus, this study aims to prove the survival benefit of thiamine use in critically ill patients with heart failure. A retrospective cohort analysis was performed on the basis of the Medical Information Mart of Intensive Care-Ⅳ database. Critically ill patients with heart failure were divided into the thiamine and non-thiamine groups depending on whether they had received thiamine therapy or not during hospitalization. The association between thiamine supplement and in-hospital mortality was assessed by using the Kaplan-Meier (KM) method and Cox proportional hazard models. A 1:1 nearest propensity-score matching (PSM) and propensity score-based inverse probability of treatment weighting (IPW) were also performed to ensure the robustness of the findings. A total of 7,021 patients were included in this study, with 685 and 6,336 in the thiamine and non-thiamine groups, respectively. The kaplan-meier survival curves indicated that the thiamine group had a lower in-hospital mortality than the none-thiamine group. After adjusting for various confounders, the Cox regression models showed significant beneficial effects of thiamine administration on in-hospital mortality among critically ill patients with heart failure with a hazard ratio of 0.78 (95% confidence interval: 0.67-0.89) in the fully adjusted model. propensity-score matching and probability of treatment weighting analyses also achieved consistent results. Thiamine supplement is associated with a decreased risk of in-hospital mortality in critically ill patients with heart failure who are admitted to the ICU. Further multicenter and well-designed randomized controlled trials with large sample sizes are necessary to validate this finding.
硫胺素缺乏在心力衰竭患者中很常见，补充硫胺素对这些患者有益。然而，在重症心力衰竭患者中，硫胺素给药与预后之间的关联仍不清楚。因此，本研究旨在证明在重症心力衰竭患者中使用硫胺素对生存的益处。基于重症监护医学信息集市-Ⅳ数据库进行了一项回顾性队列分析。重症心力衰竭患者根据住院期间是否接受硫胺素治疗分为硫胺素组和非硫胺素组。采用Kaplan-Meier（KM）法和Cox比例风险模型评估硫胺素补充与院内死亡率之间的关联。还进行了1:1最近邻倾向评分匹配（PSM）和基于倾向评分的治疗逆概率加权（IPW），以确保研究结果的稳健性。本研究共纳入7021例患者，硫胺素组和非硫胺素组分别为685例和6336例。Kaplan-Meier生存曲线表明，硫胺素组的院内死亡率低于非硫胺素组。在调整各种混杂因素后，Cox回归模型显示，硫胺素给药对重症心力衰竭患者的院内死亡率有显著益处，在完全调整模型中，风险比为0.78（95%置信区间：0.67-0.89）。倾向评分匹配和治疗加权概率分析也得出了一致的结果。补充硫胺素与入住ICU的重症心力衰竭患者院内死亡风险降低有关。需要进一步进行多中心、设计良好且样本量大的随机对照试验来验证这一发现。
