Abstract
Background
Antiplatelet agents are widely used for cardiovascular disea ses, but their pleiotropic effects in sepsis are controversial.
Objective
To investigate the association between antiplatelet agents and the survival benefit for sepsis patients.
Design
A nationwide population-based cohort and nested case–control study.
Setting
Taiwan National Health Insurance database.
Participants
All patients (age ≥18 years) who were hospitalized for sepsis between January 2000 and December 2010.
Measurements
Conditional logistic regression was used to adjust for confounding. Adjusted odd ratios (ORs) were used to compare the mortality rate due to sepsis in antiplatelet drug users and nonusers.
Results
Of 683,421 included patients, 229,792 (33.6 %) patients died during hospitalization for sepsis, and the rest (64.4 %) survived to discharge. Use of antiplatelet agents before admission was associated with a lower risk of mortality in sepsis patients (aOR 0.82, 95 % confidence interval [CI] 0.81–0.83, P < 0.001). By using another case–control study design, the beneficial effect was more significant in current users (aOR 0.78, 95 % CI 0.76–0.79) than in recent users (aOR 0.88, 95 % CI 0.85–0.91), but was not significant in past users (aOR 1.00, 95 % CI 0.98–1.02).
Limitations
Observational study.
Conclusions
Prior use of antiplatelet agents was associated with a survival benefit in sepsis patients.
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Acknowledgments
This study was based in part on data from the Taiwan National Health Insurance (NHI) Research Database provided by the Bureau of NHI, Department of Health and managed by National Health Research Institutes. The interpretations and conclusions contained herein do not represent those of Bureau of NHI, Department of Health, and National Health Research Institutes.
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Take-home message: Prior use of antiplatelet agents was associated with a survival benefit in sepsis patients.
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Tsai, MJ., Ou, SM., Shih, CJ. et al. Association of prior antiplatelet agents with mortality in sepsis patients: a nationwide population-based cohort study. Intensive Care Med 41, 806–813 (2015). https://doi.org/10.1007/s00134-015-3760-y
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DOI: https://doi.org/10.1007/s00134-015-3760-y