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Abstract:
BACKGROUND:Several studies have reported improved sepsis outcomes when certain preadmission antihypertensive drugs, namely, calcium channel blockers (CCBs), are used. This study aims to determine whether preadmission antihypertensive drug use, especially angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), is associated with decreased total hospital mortality in sepsis. METHODS:This study was conducted using the unique database of a sepsis cohort from the National Health Insurance Research Database in Taiwan. Frequency matching for age and sex between preadmission antihypertensive drug users (study cohort) and nonusers (comparison cohort) was conducted. The primary outcome was total hospital mortality. Logistic regression analyses were performed to calculate the odds ratios (ORs) of important variables. Further joint effect analyses were carried out to examine the impacts of different combinations of antihypertensive drugs. RESULTS:A total of 33,213 sepsis antihypertensive drug use patients were retrieved as the study cohort, and an equal number of matched sepsis patients who did not use antihypertensive drugs were identified as the comparison cohort. The study cohort had a higher incidence rate of being diagnosed with septic shock compared with the comparison cohort (4.36%-2.31%, P < 0.001) and a higher rate of total hospital mortality (38.42%-24.57%, P < 0.001). In the septic shock condition, preadmission antihypertensive drug use was associated with a decreased adjusted OR (OR = 0.66, 95% confidence interval [CI], 0.55-0.80) for total hospital mortality, which was not observed for the nonseptic shock condition. Compared with antihypertensive drug nonusers, both ACEI and ARB users had decreased adjusted ORs for total hospital mortality in sepsis (adjusted OR = 0.93, 95% CI, 0.88-0.98 and adjusted OR = 0.85, 95% CI, 0.81-0.90); however, CCB, beta-blocker, and diuretic users did not. In the septic shock condition, ACEI, ARB, CCB, and beta-blocker users all had decreased ORs for total hospital mortality. Joint effect analysis showed ACEI use, except in combination with diuretics, to be associated with a decreased adjusted OR for total hospital mortality in sepsis. Similar results were observed for ARB users. CONCLUSIONS:Preadmission ACEI or ARB use is associated with a decreased risk of total hospital mortality, regardless of a nonshock or septic shock condition.
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最新影响因子:3.533 | 期刊ISSN:1073-2322 | CiteScore:2.75 |
出版周期:Monthly | 是否OA:YES | 出版年份:1994 |
自引率:9.40% | 研究方向:医学-外科 |
出版地区:UNITED STATES |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
专业编辑在线一对一答疑及时解决您的问题
Shock includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. There is no single journal, which encompasses the etiology, cellular and molecular mechanisms, and therapeutic approaches to the treatment of shock in a comprehensive and coherent manner, while still maintaining a clear focus on the pathobiology of shock. The journal is poised to meet the present and future needs of investigators involved in sophisticated basic and clinical studies of shock, trauma, sepsis, endotoxemia, ischemia/reperfusion, inflammation, and other related pathophysiologic states.
休克包括研究新的治疗方法,如免疫调节、基因治疗、营养和其他。目前还没有一本包含病因、细胞和分子机制以及以综合和连贯的方式治疗休克的治疗方法的杂志,但仍保持对休克病理学的明确关注。该杂志将满足研究人员目前和未来的需求,他们参与了对休克、创伤、败血症、内毒素血症、缺血/再灌注、炎症和其他相关病理生理状态的复杂基础和临床研究。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
SURGERY (外科) 3区 CRITICAL CARE MEDICINE (危重病医学) 3区 HEMATOLOGY (血液学) 3区 PERIPHERAL VASCULAR DISEASE (外周血管病) 2区 |
15/33 27/71 26/65 42/200 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
188 | 157 | 31 |
引文计数(2018)
文献(2015-2017)
1678次引用
610篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Emergency Medicine
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#4/77
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2 |
大类(学科):Medicine
小类(学科):Critical Care and Intensive Care Medicine
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#17/84
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审稿时间: 2个月内 接受率: 比较困难(25%命中)
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研究方向:重症
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影响因子:1.714
ISSN:1386-2073
研究方向:化学-生化研究方法
影响因子:6.088
ISSN:1933-7213
研究方向:医学-神经科学
影响因子:1.379
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研究方向:医学-临床神经学
影响因子:4.287
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研究方向:CLINICAL NEUROLOGY-PHARMACOLOGY & PHARMACY
影响因子:1.821
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影响因子:2.385
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研究方向:医学-药学
影响因子:2.706
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研究方向:医学-传染病学
影响因子:4.177
ISSN:1178-6973
研究方向:-
影响因子:5.758
ISSN:0305-7453
研究方向:医学-传染病学
发表一篇学和医学成像类SCI论文
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