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

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Antiplatelet agents are widely used for cardiovascular diseases, 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.

Original languageEnglish
Pages (from-to)806-813
Number of pages8
JournalIntensive Care Medicine
Volume41
Issue number5
DOIs
Publication statusPublished - May 1 2015

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Platelet Aggregation Inhibitors
Sepsis
Cohort Studies
Mortality
Population
Confidence Intervals
Survival
National Health Programs
Drug Users
Taiwan
Observational Studies
Hospitalization
Cardiovascular Diseases
Logistic Models
Odds Ratio
Databases

Keywords

  • Antiplatelet
  • Mortality
  • Sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Association of prior antiplatelet agents with mortality in sepsis patients : a nationwide population-based cohort study. / Tsai, Min Juei; Ou, Shuo Ming; Shih, Chia Jen; Chao, Pei wen; Wang, Lan Fu; Shih, Yu Ning; Li, Szu Yuan; Kuo, Shu Chen; Hsu, Yen Tao; Chen, Yung Tai.

In: Intensive Care Medicine, Vol. 41, No. 5, 01.05.2015, p. 806-813.

Research output: Contribution to journalArticle

Tsai, Min Juei ; Ou, Shuo Ming ; Shih, Chia Jen ; Chao, Pei wen ; Wang, Lan Fu ; Shih, Yu Ning ; Li, Szu Yuan ; Kuo, Shu Chen ; Hsu, Yen Tao ; Chen, Yung Tai. / Association of prior antiplatelet agents with mortality in sepsis patients : a nationwide population-based cohort study. In: Intensive Care Medicine. 2015 ; Vol. 41, No. 5. pp. 806-813.
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AB - Background: Antiplatelet agents are widely used for cardiovascular diseases, 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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