Association of prehospitalization aspirin therapy and acute lung injury: results of a multicenter international observational study of at-risk patients.
Association of prehospitalization aspirin therapy and acute lung injury: results of a multicenter international observational study of at-risk patients.
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DOI：
10.1097/ccm.0b013e318225757f
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发表时间：
2011-11
影响因子：
8.8
通讯作者：
U.S. Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators
中科院分区：
文献类型：
--
作者：
Kor DJ;Erlich J;Gong MN;Malinchoc M;Carter RE;Gajic O;Talmor DS;U.S. Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators
在一个异质性的高危内科患者队列中评价住院前阿司匹林治疗与急性肺损伤事件之间的关系。这是一项前瞻性多中心国际队列研究的次要分析。多中心观察性研究，包括20家美国医院和2家土耳其医院。至少有一个ALI主要风险因素的连续性、成人、非手术患者入院。一个也没有。确定基线特征和ALI风险因素/修饰因子。确定阿司匹林治疗的存在和接受这种治疗的倾向。主要结局为住院期间的ALI。次要结局包括重症监护室（ICU）和住院死亡率以及ICU和住院时间。22家医院在6个月内招募了3，855名高危患者。976例（25.3%）患者在住院时正在接受阿司匹林治疗。240例（6.2%）患者发生了ALI。单变量分析显示，接受阿司匹林治疗的患者ALI发生率降低（比值比= 0.65; 95% CI = 0.46 - 0.90; p = 0.010）。在基于阿萨倾向评分十分位数的分层分析中，这种相关性减弱（Cochran-Mantel-Haenszel合并比值比= 0.70; 95% CI = 0.48 - 1.03; p = 0.072）。在调整了接受阿司匹林治疗的倾向后，未发现住院前阿司匹林治疗与ALI之间存在统计学显著相关性;然而，进一步评估这种相关性的前瞻性临床试验似乎是必要的。
To evaluate the association between pre-hospitalization aspirin therapy and incident acute lung injury in a heterogeneous cohort of at-risk medical patients. This is a secondary analysis of a prospective multicenter international cohort investigation. Multicenter observational study including 20 US hospitals and 2 hospitals in Turkey. Consecutive, adult, non-surgical patients admitted to the hospital with at least one major risk factor for ALI. None. Baseline characteristics and ALI risk factors/modifiers were identified. The presence of aspirin therapy and the propensity to receive this therapy were determined. The primary outcome was ALI during hospitalization. Secondary outcomes included intensive care unit (ICU) and hospital mortality and ICU and hospital length of stay. Twenty-two hospitals enrolled 3,855 at-risk patients over a 6-month period. Nine hundred and seventy-six (25.3%) were receiving aspirin at the time of hospitalization. Two hundred and forty (6.2%) patients developed ALI. Univariate analysis noted a reduced incidence of ALI in those receiving aspirin therapy (odds ratio = 0.65; 95% CI = 0.46 to 0.90; p = 0.010). This association was attenuated in a stratified analysis based on deciles of ASA propensity scores (Cochran-Mantel-Haenszel pooled odds ratio = 0.70; 95% CI = 0.48 – 1.03; p = 0.072). After adjusting for the propensity to receive aspirin therapy, no statistically significant associations between pre-hospitalization aspirin therapy and ALI were identified; however, a prospective clinical trial to further evaluate this association appears warranted.