PDF(Pubmed)
Abstract：
UNASSIGNED: Basic studies show that selective 5-hydroxytryptamine type 3 (5-HT3) serotonin-receptor antagonists can protect organs from inflammatory injury and have shown lung protection. Whether 5-HT3 receptor antagonists ondansetron benefits patients with mechanical ventilation is unclear in the intensive care unit (ICU).
UNASSIGNED: The Medical Information Mart for Intensive Care-IV (MIMIC-IV) database was reviewed to identify patients on mechanical ventilation (aged >16 years) in the ICU, which was divided into two groups according to whether ondansetron is used. Demographic characteristics, medical history data, clinical parameters, diagnosis and treatment measures were included as covariates. Ondansetron use was defined as any kind of ondansetron administration regardless of the dose before the induction of mechanical ventilation. The primary outcome was in-hospital death. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated by multivariable Cox regression. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to further adjust for confounding factors. Kaplan-Meier (KM) curves with log-rank test were also performed.
UNASSIGNED: A total of 18,566 patients on mechanical ventilation were included (5,735 with ondansetron use). The overall in-hospital mortality rate of patients on mechanical ventilation was 18.9% (3,512/18,566). Approximately 13.0% (746/5,735) and 21.6% (2,766/12,831) in-hospital mortality rates occurred in the ondansetron and non-ondansetron use groups, respectively. Multivariable regression indicated that ondansetron usage was associated with a 33% and 32% lower risk of in-hospital and 60-day death (HR =0.77, 95% CI: 0.70-0.85, P<0.001; HR =0.68, 95% CI: 0.62-0.75, P<0.001) in the whole sample. Multivariable regression post-PSM indicated that ondansetron usage was associated with a 38% and 31% lower risk of in-hospital and 60-day death (HR =0.62, 95% CI: 0.56-0.68, P<0.001; HR =0.69, 95% CI: 0.62-0.77, P<0.001). Log-rank test for the KM curve of ondansetron and 60-day death was statistically significant (P<0.001). The duration of ventilator use pre- and post-PSM was statistically different (P<0.001 and P=0.007) in the two groups.
UNASSIGNED: Ondansetron usage was significantly associated with a lower mortality risk of ventilated patients in the ICU. The 5-HT3 receptor antagonist use is may be new potential adjunctive therapeutic strategy for patients on mechanical ventilation in the ICU.
UNASSIGNED: The Medical Information Mart for Intensive Care-IV (MIMIC-IV) database was reviewed to identify patients on mechanical ventilation (aged >16 years) in the ICU, which was divided into two groups according to whether ondansetron is used. Demographic characteristics, medical history data, clinical parameters, diagnosis and treatment measures were included as covariates. Ondansetron use was defined as any kind of ondansetron administration regardless of the dose before the induction of mechanical ventilation. The primary outcome was in-hospital death. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated by multivariable Cox regression. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to further adjust for confounding factors. Kaplan-Meier (KM) curves with log-rank test were also performed.
UNASSIGNED: A total of 18,566 patients on mechanical ventilation were included (5,735 with ondansetron use). The overall in-hospital mortality rate of patients on mechanical ventilation was 18.9% (3,512/18,566). Approximately 13.0% (746/5,735) and 21.6% (2,766/12,831) in-hospital mortality rates occurred in the ondansetron and non-ondansetron use groups, respectively. Multivariable regression indicated that ondansetron usage was associated with a 33% and 32% lower risk of in-hospital and 60-day death (HR =0.77, 95% CI: 0.70-0.85, P<0.001; HR =0.68, 95% CI: 0.62-0.75, P<0.001) in the whole sample. Multivariable regression post-PSM indicated that ondansetron usage was associated with a 38% and 31% lower risk of in-hospital and 60-day death (HR =0.62, 95% CI: 0.56-0.68, P<0.001; HR =0.69, 95% CI: 0.62-0.77, P<0.001). Log-rank test for the KM curve of ondansetron and 60-day death was statistically significant (P<0.001). The duration of ventilator use pre- and post-PSM was statistically different (P<0.001 and P=0.007) in the two groups.
UNASSIGNED: Ondansetron usage was significantly associated with a lower mortality risk of ventilated patients in the ICU. The 5-HT3 receptor antagonist use is may be new potential adjunctive therapeutic strategy for patients on mechanical ventilation in the ICU.
摘要：
UNASSIGNED：基础研究表明，选择性5-羟色胺3型（5-HT3）5-羟色胺受体拮抗剂可以保护器官免受炎症损伤，并已显示出肺保护作用。重症监护病房（ICU）尚不清楚5-HT3受体拮抗剂昂丹司琼是否对机械通气患者有益。
UNASSIGNED：对重症监护医学信息集市（MIMIC-IV）数据库进行了审查，以识别ICU中机械通气（年龄>16岁）的患者，根据是否使用昂丹司琼分为两组。人口特征，病史资料,临床参数,包括诊断和治疗措施作为协变量.昂丹司琼的使用定义为任何类型的昂丹司琼给药，无论诱导机械通气前的剂量如何。主要结果是院内死亡。通过多变量Cox回归计算具有95％置信区间（CI）的危险比（HR）。进行倾向评分匹配（PSM）和治疗加权逆概率（IPTW）以进一步调整混杂因素。还进行了具有对数秩检验的Kaplan-Meier(KM)曲线。
UNASSIGNED：共纳入18,566例机械通气患者（5,735例使用昂丹司琼）。机械通气患者的总体住院死亡率为18.9%(3,512/18,566)。昂丹司琼和非昂丹司琼使用组的住院死亡率约为13.0%(746/5,735)和21.6%(2,766/12,831)，分别。多变量回归分析显示，在整个样本中，使用昂丹司琼与住院和60天死亡风险降低33%和32%相关（HR=0.77，95%CI：0.70-0.85，P<0.001；HR=0.68，95%CI：0.62-0.75，P<0.001）。PSM后的多变量回归表明，昂丹司琼的使用与住院和60天死亡风险降低38％和31％相关（HR=0.62，95％CI：0.56-0.68，P<0.001；HR=0.69，95％CI：0.62-0.77，P<0.001）。昂丹司琼的KM曲线与60天死亡的Log-rank检验有统计学意义（P<0.001）。两组PSM前后呼吸机使用时间差异有统计学意义（P<0.001和P=0.007）。
UNASSIGNED：使用昂丹司琼与ICU中通气患者的较低死亡风险显著相关。5-HT3受体拮抗剂的使用可能是ICU机械通气患者新的潜在辅助治疗策略。
UNASSIGNED：对重症监护医学信息集市（MIMIC-IV）数据库进行了审查，以识别ICU中机械通气（年龄>16岁）的患者，
UNASSIGNED：共纳入18,566例机械通气患者（5,735例使用昂丹司琼）。
UNASSIGNED：使用昂丹司琼与ICU中通气患者的较低死亡风险显著相关。
