■本项目旨在比较不同法莫替丁给药途径的非创伤性脑出血(ICH)患者的生存结果,并探讨影响患者临床结局的危险因素。
■从2008年至2019年入住ICU并接受法莫替丁治疗的患者数据收集自医学信息集市重症监护IV(MIMIC-IV)数据库。选择ICU入院>1天且用法莫替丁治疗的患者被分为通过静脉内(IV)给药组和通过非静脉内(非IV)给药组。Cox分析和双侧逐步回归分析用于确定影响患者生存的独立预后因素。使用Kaplan-Meier(K-M)存活曲线比较倾向评分匹配(PSM)前后不同给药途径患者的存活率。
■这项调查包括351名患者。PSM以1:2的比例匹配后,109例患者聚集在IV组中,84例患者聚集在非IV组中。Cox多变量结果显示,接受法莫替丁治疗的ICH患者的生存预后与年龄相关(HR=1.031,95CI:1.011-1.050,p=0.002),氯离子水平(HR=1.061,95CI:1.027-1.096,p<0.001),血尿素氮(BUN)(HR=1.034,95CI:1.007-1.062,p=0.012),颅内压(ICP)(HR=1.059,95CI:1.027-1.092,p<0.001),红细胞分布宽度(RDW)(HR=1.156,95CI:1.030-1.299,p=0.014),机械通气(HR=2.526,95CI:1.341-4.760,p=0.004),抗生素使用(HR=0.331,95CI:0.144-0.759,p=0.009),和非静脉途径(HR=0.518,95CI:0.283-0.948,p=0.033)。K-M曲线结果表明,非IV组ICH患者的30天生存率明显高于IV组患者(PSM前,p=0.036;PSM后,p=0.011)。在年龄的亚组分析中,ICP,机械通气,和抗生素的使用,法莫替丁的给药与30天死亡率之间存在很大的异质性相互作用(P<0.05)。非静脉途径大大降低了ICP正常(7-15mmHg)患者的死亡风险(HR=0.518,95CI:0.283-0.948,p=0.033)。
■在接受法莫替丁的ICH患者中,那些通过非静脉注射接受法莫替丁的人比接受静脉注射的人有更好的30天生存率,尤其是ICP正常(7-15mmHg)的患者。
UNASSIGNED: This project aims to compare the survival outcomes of non-traumatic intracerebral hemorrhage (ICH) patients with different famotidine administration routes, and explore the risk factors influencing patients\' clinical outcomes.
UNASSIGNED: Data of patients admitted to the ICU from 2008 to 2019 and receiving famotidine therapy were collected from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Patients selected for ICU admission > 1 day and treated with famotidine were divided into the group via
intravenous (IV) dosing and the group via non-
intravenous (Non-IV) dosing. Cox analysis and bilateral stepwise regression were utilized to determine independent prognostic factors affecting patient survival. Survival of patients on different routes of administration before and after propensity score matching (PSM) was compared using Kaplan - Meier (K-M) survival curves.
UNASSIGNED: This investigation included 351 patients. After PSM was matched with a 1:2 ratio, 109 patients were clustered in the IV group and 84 patients in the Non-IV group. Cox multivariate results uncovered that survival prognosis in ICH patients receiving famotidine was associated with age (HR = 1.031, 95%CI:1.011-1.050, p = 0.002), chloride ion levels (HR = 1.061, 95%CI:1.027-1.096, p < 0.001), blood urea nitrogen (BUN) (HR = 1.034, 95%CI:1.007-1.062, p = 0.012), intracranial pressure (ICP) (HR = 1.059, 95%CI:1.027-1.092, p < 0.001), red blood cell distribution width (RDW) (HR = 1.156, 95%CI:1.030-1.299, p = 0.014), mechanical ventilation (HR = 2.526, 95%CI:1.341-4.760, p = 0.004), antibiotic use (HR = 0.331, 95%CI:0.144-0.759, p = 0.009), and Non-IV route (HR = 0.518, 95%CI:0.283-0.948, p = 0.033). The K-M curve results indicated that the 30-day survival rate of Non-IV group ICH patients was substantially higher than that of IV group patients (before PSM, p = 0.036; after PSM, p = 0.011). In the subgroup analysis of age, ICP, mechanical ventilation, and antibiotic use, there was a great heterogeneity interaction between the administration of famotidine and the 30-day mortality rate (P for interaction < 0.05). The Non-IV route considerably reduced the risk of death in patients with normal ICP (7-15 mmHg) (HR = 0.518, 95%CI:0.283-0.948, p = 0.033).
UNASSIGNED: Among ICH patients receiving famotidine, those receiving famotidine via Non-IV have a better 30-day survival rate compared to those receiving IV, especially in patients with normal ICP (7-15 mmHg).