Association of PPIs use with short-term and long-term mortality risk in patients with severe ischemic stroke: a retrospective cohort study based on the MIMIC-Ⅲ database

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Author: QIN Sisi ¹ ZHANG Huitao ¹ PAN Haiyan ¹ ZHU Yaoli ¹  ZENG Li ²

Affiliation: 1. Department of Critical Care Medicine, the Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai 519000, Guangdong Province, China 2. Department of Neurology, the Second Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang 550003, China

Keywords: Proton pump inhibitors Severe ischemic stroke Mortality risk MIMIC-Ⅲ database

DOI: 10.12173/j.issn.1005-0698.202306088

Reference: QIN Sisi, ZHANG Huitao, PAN Haiyan, ZHU Yaoli, ZENG Li.Association of PPIs use with short-term and long-term mortality risk in patients with severe ischemic stroke: a retrospective cohort study based on the MIMIC-Ⅲ database[J].Yaowu Liuxingbingxue Zazhi,2024, 33(1):45-51.DOI: 10.12173/j.issn.1005-0698.202306088.[Article in Chinese]  Copied

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Abstract

Objective To investigate the association of proton pump inhibitors (PPIs) use with short-term and long-term mortality risk in patients with severe ischemic stroke.

Methods This retrospective study based on the U.S. Medical Information Mark for Intensive Care Ⅲ (MIMIC-Ⅲ) database, ICU patients aged ≥18 years with the first ICU admission and a diagnosis of ischemic stroke were finally included in the study. All enrolled subjects were divided into PPIs group and non-PPIs group according to whether they had used PPIs (pantoprazole, lansoprazole and omeprazole) during hospitalization. Kaplan-Meier survival analyses and Cox regression models were used to analyze the association between the use of PPIs and the risk of ICU death, 30 d risk of death, 90 d risk of death in patients with severe ischemic stroke.

Results A total of 1 015 patients were included, 402 cases in the PPIs group and 613 in the non-PPIs group. The ICU-mortality, 30 d and 90 d mortality were 15.37%, 13.60% and 20.10%, respectively. Kaplan-Meier survival analyses illustrated that the PPIs group survived better than non-PPIs group in ICU mortality analysis (P=0.002). In Cox regression analysis, after adjustment for potential confounders, the hazard ratio (HR) for ICU mortality in the PPIs group relative to the non-PPIs group was 0.671 9 (95%CI 0.478 8 to 0.942 8, P=0.021), but there was no significant difference between 30 d and 90 d mortality (P>0.05).

Conclusion In patients with severe ischemic stroke, the use of PPIs may be effective in reducing the risk of ICU death, but does not improve 30 d and 90 d risk of death in patients.

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