使用阿司匹林对心肌梗死和肺炎患者预后的影响。

IF 1.4 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Minerva cardiology and angiology Pub Date : 2024-05-27 DOI:10.23736/S2724-5683.24.06467-6
Jialun Ye, Jieqiong Chen, Sheng Chen
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引用次数: 0

摘要

背景我们旨在探讨使用阿司匹林对心肌梗死和肺炎患者再入院风险和死亡率的影响:这是一项队列研究,包括重症监护医学信息市场(MIMIC)-III和MIMIC-IV中的703名重症肺炎和心肌梗死患者。研究采用卡普兰-米尔生存分析法来显示使用或不使用阿司匹林患者的再入院和生存概率。此外,还采用了单变量和多变量模型来研究阿司匹林对患者再入院或死亡风险的影响。根据年龄、性别、抗生素使用情况、万古霉素和氨苄西林使用情况进行了分组分析:平均随访时间为一年,22%的患者再次入院,72%的患者存活。对混杂因素进行调整后发现,使用阿司匹林的患者再入院风险降低了0.46倍(危险比[HR]=0.46,95%置信区间[CI]:0.27-0.78),一年内死亡风险降低了0.58倍(HR=0.56,95%置信区间[CI]:0.42-0.82)。亚组分析显示,阿司匹林与未接受万古霉素治疗的患者的死亡风险增加有关(HR=1.79,95%CI:1.08-2.97):我们的研究结果表明,临床医生应考虑对严重心肌梗死和肺炎患者使用阿司匹林。
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Impacts of aspirin use on the prognosis of patients with myocardial infarction and pneumonia.

Background: We aimed to explore the impact of aspirin use on the risk of readmission and mortality in patients with myocardial infarction and pneumonia.

Methods: This was a cohort study including 703 participants with severe pneumonia and myocardial infarction included in the Medical Information Mart for Intensive Care (MIMIC)-III and the MIMIC-IV. Kaplan-Meier survival analysis was used to show the readmission and survival probability of patients with or without aspirin. In addition, univariate and multivariable models were used to investigate the impact of aspirin on the risk of readmission or mortality of patients. Subgroup analyses were conducted in terms of age, gender, antibiotic use, vancomycin and ampicillin use.

Results: Average follow-up was one year, 22% of patients experienced readmission, and 72% patients survived. After the confounders were adjusted for, a 0.46-fold decreased risk of readmission (hazard ratio [HR]=0.46, 95% confidence interval [CI]: 0.27-0.78) and a 0.58-fold decreased risk of one-year mortality (HR=0.56, 95%CI: 0.42-0.82) were observed favoring aspirin use. Subgroup analyses revealed that aspirin was, however, associated with an increased risk of mortality in patients not receiving vancomycin treatment (HR=1.79, 95%CI: 1.08-2.97).

Conclusions: Our findings suggest that clinicians should consider using aspirin in patients with severe myocardial infarction and pneumonia was recommended.

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来源期刊
Minerva cardiology and angiology
Minerva cardiology and angiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.60
自引率
18.80%
发文量
118
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