PDF(Pubmed)
Abstract：
UNASSIGNED: Traumatic brain injury (TBI) patients suffer high risks of mortality. Ondansetron has been verified to be effective in improving the prognosis of some kinds of critically ill patients. We design this study to explore whether ondansetron use is associated with lower risks of mortality among TBI patients.
UNASSIGNED: TBI patients from the Medical Information Mart for Intensive Care-III were collected. The usage of ondansetron, including intravenous injection and oral tablet, since admission to the Beth Israel Deaconess Medical Center between 2001 and 2012 was identified. Univariate and multivariate logistic regression were performed to analyze the relationship between the ondansetron use and mortality of TBI patients. Propensity score matching (PSM) was utilized to generate balanced cohorts of the non-ondansetron use group and ondansetron use group. Sub-group analysis was performed to verify the association between the ondansetron use and mortality of TBI patients in different TBI severity levels after PSM.
UNASSIGNED: In TBI cohorts before PSM, the usage incidence of ondansetron was 37.2%. The 30-day mortality was significantly lower in the ondansetron group (p < 0.001). The multivariate logistic regression showed that ondansetron was associated with the lower mortality of TBI patients (p = 0.008). In TBI cohorts after PSM, the 30-day mortality of the ondansetron group was lower than that of the non-ondansetron group, although without statistical significance (p = 0.079). Logistic regression indicated ondansetron use was significantly associated with the lower mortality of moderate-to-severe TBI (p < 0.001) but not mild TBI (p = 0.051). In addition, Cox regression also presented that ondansetron use was significantly associated with the lower mortality of moderate-to-severe TBI (p < 0.001) but not mild TBI (p = 0.052).
UNASSIGNED: Ondansetron usage is associated with a lower mortality risk of moderate-to-severe TBI but not mild TBI patients. Ondansetron may be a novel adjunctive therapeutic strategy to improve the prognosis of moderate-to-severe TBI patients.
UNASSIGNED: TBI patients from the Medical Information Mart for Intensive Care-III were collected. The usage of ondansetron, including intravenous injection and oral tablet, since admission to the Beth Israel Deaconess Medical Center between 2001 and 2012 was identified. Univariate and multivariate logistic regression were performed to analyze the relationship between the ondansetron use and mortality of TBI patients. Propensity score matching (PSM) was utilized to generate balanced cohorts of the non-ondansetron use group and ondansetron use group. Sub-group analysis was performed to verify the association between the ondansetron use and mortality of TBI patients in different TBI severity levels after PSM.
UNASSIGNED: In TBI cohorts before PSM, the usage incidence of ondansetron was 37.2%. The 30-day mortality was significantly lower in the ondansetron group (p < 0.001). The multivariate logistic regression showed that ondansetron was associated with the lower mortality of TBI patients (p = 0.008). In TBI cohorts after PSM, the 30-day mortality of the ondansetron group was lower than that of the non-ondansetron group, although without statistical significance (p = 0.079). Logistic regression indicated ondansetron use was significantly associated with the lower mortality of moderate-to-severe TBI (p < 0.001) but not mild TBI (p = 0.051). In addition, Cox regression also presented that ondansetron use was significantly associated with the lower mortality of moderate-to-severe TBI (p < 0.001) but not mild TBI (p = 0.052).
UNASSIGNED: Ondansetron usage is associated with a lower mortality risk of moderate-to-severe TBI but not mild TBI patients. Ondansetron may be a novel adjunctive therapeutic strategy to improve the prognosis of moderate-to-severe TBI patients.
摘要：
■创伤性脑损伤（TBI）患者的死亡风险很高。昂丹司琼已被证实可有效改善某些危重患者的预后。我们设计了这项研究，以探讨在TBI患者中使用昂丹司琼是否与较低的死亡风险相关。
■收集来自医疗信息集市的重症监护III的TBI患者。昂丹司琼的用法,包括静脉注射和口服片剂，自2001年至2012年被确认进入贝斯以色列女执事医疗中心以来。采用单因素和多因素logistic回归分析昂丹司琼使用与TBI患者病死率的关系。使用倾向评分匹配（PSM）来生成非昂丹西酮使用组和昂丹司琼使用组的平衡队列。进行亚组分析以验证恩丹西酮的使用与PSM后不同TBI严重程度TBI患者死亡率之间的关系。
■在PSM之前的TBI队列中，昂丹司琼的使用率为37.2%。昂丹司琼组30天死亡率显著降低(p<0.001)。多因素logistic回归分析显示昂丹司琼与TBI患者死亡率较低相关(p=0.008)。在PSM后的TBI队列中，昂丹司琼组的30天死亡率低于非昂丹司琼组，虽然没有统计学意义（p=0.079）。Logistic回归分析显示，使用昂丹司琼与中重度TBI的死亡率降低显著相关（p<0.001），但与轻度TBI的死亡率无关（p=0.051）。此外,Cox回归还显示，使用昂丹司琼与中重度TBI的死亡率降低显著相关（p<0.001），但与轻度TBI的死亡率无关（p=0.052）。
■昂丹司琼的使用与中度至重度TBI而不是轻度TBI患者的较低死亡风险相关。昂丹司琼可能是改善中重度TBI患者预后的一种新的辅助治疗策略。
■收集来自医疗信息集市的重症监护III的TBI患者。昂丹司琼的用法,包括静脉注射和口服片剂，自2001年至2012年被确认进入贝斯以色列女执事医疗中心以来。采用单因素和多因素logistic回归分析昂丹司琼使用与TBI患者病死率的关系。使用倾向评分匹配（PSM）来生成非昂丹西酮使用组和昂丹司琼使用组的平衡队列。进行亚组分析以验证恩丹西酮的使用与PSM后不同TBI严重程度TBI患者死亡率之间的关系。
■在PSM之前的TBI队列中，昂丹司琼的使用率为37.2%。昂丹司琼组30天死亡率显著降低(p<0.001)。多因素logistic回归分析显示昂丹司琼与TBI患者死亡率较低相关(p=0.008)。在PSM后的TBI队列中，昂丹司琼组的30天死亡率低于非昂丹司琼组，虽然没有统计学意义（p=0.079）。Logistic回归分析显示，使用昂丹司琼与中重度TBI的死亡率降低显著相关（p<0.001），但与轻度TBI的死亡率无关（p=0.051）。此外,Cox回归还显示，使用昂丹司琼与中重度TBI的死亡率降低显著相关（p<0.001），但与轻度TBI的死亡率无关（p=0.052）。
■昂丹司琼的使用与中度至重度TBI而不是轻度TBI患者的较低死亡风险相关。昂丹司琼可能是改善中重度TBI患者预后的一种新的辅助治疗策略。
