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Association of prior antiplatelet agents with mortality in sepsis patients: a nationwide population-based cohort study

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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.

Conflicts of interest

We declare that we have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Taipei Veterans General Hospital, Suao Branch, Yilan, Taiwan

    Min-Juei Tsai

  2. National Yang-Ming University School of Medicine, Taipei, Taiwan

    Min-Juei Tsai, Shuo-Ming Ou, Chia-Jen Shih, Szu-Yuan Li, Shu-Chen Kuo & Yung-Tai Chen

  3. Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Shuo-Ming Ou & Szu-Yuan Li

  4. Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan

    Chia-Jen Shih

  5. Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan

    Pei-wen Chao

  6. Miaoli General Hospital, Ministry of Health and Welfare Chest Department, Miaoli City, Taiwan

    Lan-Fu Wang

  7. Department of Chest, Taipei City Hospital Heping Fuyou Branch, Taipei, 112, Taiwan

    Yu-Ning Shih & Yen-Tao Hsu

  8. National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli City, Miaoli County, Taiwan

    Shu-Chen Kuo

  9. Division of Infectious Diseases, Taipei Veterans General Hospital, Taipei, Taiwan

    Shu-Chen Kuo

  10. Department of Nephrology, Taipei City Hospital Heping Fuyou Branch, Taipei, 112, Taiwan

    Yung-Tai Chen

Authors
  1. Min-Juei Tsai
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  9. Yen-Tao Hsu
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  10. Yung-Tai Chen
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Corresponding authors

Correspondence to Yen-Tao Hsu or Yung-Tai Chen.

Additional information

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

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