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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 Hsu| Yung-Tai Chen
Original
Volume 41, Issue 5 / May , 2015

Pages 806 - 813

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

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