Xu Jian, Zhang Mengfei, Tao Leyu, Zhang Shuying, Tang Zhihua
Department of Pharmacy, Shaoxing People's Hospital, Shaoxing, China.
Front Pharmacol. 2025 Sep 9;16:1604117. doi: 10.3389/fphar.2025.1604117. eCollection 2025.
Stroke is a major global public - health problem. It is a cerebrovascular disease with sudden onset, high prevalence, and high rates of death and disability. Ondansetron (a 5 - HT3 receptor antagonist) an antiemetic, has recently been indicated in studies to have the ability to influence neurotransmitter imbalance, towardly have more effective against vomiting in stroke patients. However, its impact on stroke patients' clinical outcomes remains unclear. This study uses real - world data to evaluate ondansetron's effect on stroke patients' clinical outcomes. Findings could lead to new treatments and better outcomes.
This study was a retrospective cohort analysis involving adult patients who experienced a stroke, categorized into two groups: the ondansetron group and the non-ondansetron group. To ensure the baseline characteristics were balanced, propensity score matching (PSM) was utilized. The mortality rate was assessed using multivariable Cox regression models along with Kaplan-Meier survival curves. Additionally, subgroup analyses were performed to examine the consistency of the findings.
A total of 5,297 stroke patients were included in this study, among which 3,926 stroke patients received ondansetron treatment on the first day of admission to the intensive care unit (ICU), and 1,371 did not receive this drug treatment. After PSM, 2,628 patients were paired. The analysis results showed that the use of ondansetron on the first day of admission to the ICU significantly reduced the 30-day mortality rate (hazard ratio [HR] 0.73, 95% confidence interval [CI]: 0.59-0.92, P < 0.05). Meanwhile, the 60-day mortality rate also decreased significantly (HR 0.73, 95% CI: 0.60-0.90, P < 0.05).
Treatment using ondansetron is linked to an enhancement in the overall prognosis for stroke patients. Those who are administered ondansetron on the initial day of their ICU admission experience a notably lower mortality rate. The results of this research provide a compelling and valuable addition to the conventional stroke treatment protocol, holding considerable clinical importance and scientific research relevance.
中风是一个重大的全球公共卫生问题。它是一种脑血管疾病，具有起病突然、患病率高以及死亡率和致残率高的特点。昂丹司琼（一种5-羟色胺3受体拮抗剂）作为一种止吐药，最近的研究表明它有能力影响神经递质失衡，从而对中风患者的呕吐更有效。然而，其对中风患者临床结局的影响仍不明确。本研究使用真实世界数据来评估昂丹司琼对中风患者临床结局的影响。研究结果可能会带来新的治疗方法并改善预后。
本研究是一项回顾性队列分析，纳入了成年中风患者，分为两组：昂丹司琼组和非昂丹司琼组。为确保基线特征平衡，采用了倾向得分匹配（PSM）方法。使用多变量Cox回归模型和Kaplan-Meier生存曲线评估死亡率。此外，进行了亚组分析以检验研究结果的一致性。
本研究共纳入5297例中风患者，其中3926例中风患者在重症监护病房（ICU）入院第一天接受了昂丹司琼治疗，1371例未接受该药物治疗。经过PSM后，配对了2628例患者。分析结果显示，在ICU入院第一天使用昂丹司琼可显著降低30天死亡率（风险比[HR]0.73，95%置信区间[CI]：0.59 - 0.92，P < 0.05）。同时，60天死亡率也显著降低（HR 0.73，95%CI：0.60 - 0.90，P < 0.05）。
使用昂丹司琼治疗与中风患者总体预后的改善有关。在ICU入院首日接受昂丹司琼治疗的患者死亡率显著降低。本研究结果为传统中风治疗方案增添了有力且有价值的内容，具有相当的临床重要性和科研相关性。
