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Intensive Care Medicine

, Volume 41, Issue 5, pp 806–813 | Cite as

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

  • Min-Juei Tsai
  • Shuo-Ming Ou
  • Chia-Jen Shih
  • Pei-wen Chao
  • Lan-Fu Wang
  • Yu-Ning Shih
  • Szu-Yuan Li
  • Shu-Chen Kuo
  • Yen-Tao HsuEmail author
  • Yung-Tai ChenEmail author
Original

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.

Keywords

Sepsis Antiplatelet Mortality 

Notes

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.

Supplementary material

134_2015_3760_MOESM1_ESM.docx (30 kb)
Supplementary material 1 (DOCX 30 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2015

Authors and Affiliations

  • Min-Juei Tsai
    • 1
    • 2
  • Shuo-Ming Ou
    • 2
    • 3
  • Chia-Jen Shih
    • 2
    • 4
  • Pei-wen Chao
    • 5
  • Lan-Fu Wang
    • 6
  • Yu-Ning Shih
    • 7
  • Szu-Yuan Li
    • 2
    • 3
  • Shu-Chen Kuo
    • 2
    • 8
    • 9
  • Yen-Tao Hsu
    • 7
    Email author
  • Yung-Tai Chen
    • 2
    • 10
    Email author
  1. 1.Department of Internal MedicineTaipei Veterans General HospitalYilanTaiwan
  2. 2.National Yang-Ming University School of MedicineTaipeiTaiwan
  3. 3.Division of Nephrology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
  4. 4.Department of MedicineTaipei Veterans General HospitalYilanTaiwan
  5. 5.Department of Anesthesiology, Wan Fang HospitalTaipei Medical UniversityTaipeiTaiwan
  6. 6.Miaoli General HospitalMinistry of Health and Welfare Chest DepartmentMiaoli CityTaiwan
  7. 7.Department of ChestTaipei City Hospital Heping Fuyou BranchTaipeiTaiwan
  8. 8.National Institute of Infectious Diseases and VaccinologyNational Health Research InstitutesMiaoli CityTaiwan
  9. 9.Division of Infectious DiseasesTaipei Veterans General HospitalTaipeiTaiwan
  10. 10.Department of NephrologyTaipei City Hospital Heping Fuyou BranchTaipeiTaiwan

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