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早期使用阿司匹林与脓毒症患者90天死亡率的关联:基于MIMIC-IV数据库的倾向评分匹配分析

Association of early aspirin use with 90-day mortality in patients with sepsis: an PSM analysis of the MIMIC-IV database.

作者信息

Huang Chunsheng, Tong Qiaoling, Zhang Wenyuan, Pan Zhihao

机构信息

Department of Anesthesiology, Ningbo Medical Center Lihuili Hospital, Medical School of Ningbo University, Ningbo, China.

Department of Otolaryngology, Ningbo No.2 Hospital, Ningbo, China.

出版信息

Front Pharmacol. 2025 Jan 9;15:1475414. doi: 10.3389/fphar.2024.1475414. eCollection 2024.

Abstract

OBJECTIVE

In addition to its antiplatelet and anti-inflammatory properties, aspirin inhibits bacterial proliferation directly. The potential benefits of aspirin may enhance the prognosis for sepsis patients. However, little is known about the effects of early aspirin administration. This study aimed to examine the correlation between the administration of aspirin at an early stage and the 90-day mortality rate among sepsis patients.

METHODS

In order to distinguish between septic patients who received early aspirin treatment and those who did not, queries were conducted on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The principal metric utilized was 90-day mortality. We determined the association between early aspirin use and 90-day mortality using multivariate Cox regression, and propensity score matching (PSM) was utilized to validate our findings. The analyses of the subgroups have been completed.

RESULTS

Our analysis comprised 28,425 septic patients, of whom 7,568 (26.6%) received aspirin within 24 h of intensive care unit (ICU) admission. The aspirin users group had a lower 90-day mortality than the aspirin nonusers group [1,624 (21.8%) vs. 2,035 (27.3%), < 0.001]. The logistic regression showed that early aspirin use was associated with a lower 90-day mortality (OR, 0.74, 95% CI, 0.69-0.80, < 0.001). K-M curve analysis showed that the 90-day mortality of the aspirin users group was significantly lower than that of the aspirin nonusers group ( < 0.001). Subgroup analysis revealed comparable relationships between early aspirin use and 90-day mortality among individuals.

CONCLUSION

In conclusion, early aspirin use was associated with decreased in-hospital and 90-day mortality in septic patients, emphasizing the significance of early aspirin use administration in the ICU.

摘要

目的

除具有抗血小板和抗炎特性外,阿司匹林还可直接抑制细菌增殖。阿司匹林的潜在益处可能会改善脓毒症患者的预后。然而,关于早期使用阿司匹林的效果知之甚少。本研究旨在探讨脓毒症患者早期使用阿司匹林与90天死亡率之间的相关性。

方法

为区分接受早期阿司匹林治疗的脓毒症患者和未接受治疗的患者,对重症监护医学信息集市IV(MIMIC-IV)数据库进行了查询。主要指标为90天死亡率。我们使用多变量Cox回归确定早期使用阿司匹林与90天死亡率之间的关联,并采用倾向得分匹配(PSM)来验证我们的研究结果。已完成亚组分析。

结果

我们的分析纳入了28425例脓毒症患者,其中7568例(26.6%)在重症监护病房(ICU)入院后24小时内接受了阿司匹林治疗。阿司匹林使用者组的90天死亡率低于未使用者组[1624例(21.8%)对2035例(27.3%),<0.001]。逻辑回归显示,早期使用阿司匹林与较低的90天死亡率相关(OR,0.74;95%CI,0.69-0.80;<0.001)。K-M曲线分析显示,阿司匹林使用者组的90天死亡率显著低于未使用者组(<0.001)。亚组分析揭示了个体中早期使用阿司匹林与90天死亡率之间的类似关系。

结论

总之,早期使用阿司匹林与脓毒症患者住院期间及90天死亡率降低相关,强调了在ICU早期使用阿司匹林的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c35/11754289/aa93dd300dc6/fphar-15-1475414-g001.jpg

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