| アイテムタイプ |
学術雑誌論文 / Journal Article(1) |
| 公開日 |
2025-10-28 |
| タイトル |
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タイトル |
Association between early administration of mucoactive agents and in-hospital mortality in patients with pneumonia requiring mechanical ventilation: a nationwide cohort study |
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言語 |
en |
| 言語 |
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言語 |
eng |
| キーワード |
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言語 |
en |
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キーワード |
Acute respiratory failure |
| キーワード |
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言語 |
en |
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キーワード |
Doubly robust |
| キーワード |
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言語 |
en |
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キーワード |
Inverse probability of treatment weighting |
| キーワード |
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言語 |
en |
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キーワード |
Mortality |
| キーワード |
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言語 |
en |
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キーワード |
Propensity score overlap weighting |
| キーワード |
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言語 |
en |
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キーワード |
Sputum |
| 資源タイプ |
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資源タイプ |
journal article |
| アクセス権 |
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アクセス権 |
open access |
| 著者 |
佐々木, 朗
WEKO
35195
e-Rad_Researcher
20794663
| ja |
佐々木, 朗
宮崎大学
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| ja-Kana |
ササキ, アキラ
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| en |
Sasaki, Akira
University of Miyazaki
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Search repository
Nakajima, Mikio
Shinozaki, Tomohiro
Sasabuchi, Yusuke
Ohbe, Hiroyuki
Kaszynski, Richard H
| en |
Kaszynski, Richard H（Personal）
Tokyo Metropolitan Hiroo Hospital
|
Search repository
Kimura, Yuya
Morita, Kojiro
Goto, Tadahiro
Aiyama, Yuki
Nakayama, Izumi
Matsui, Hiroki
Fushimi, Kiyohide
落合, 秀信
WEKO
28646
e-Rad_Researcher
40224258
| ja |
落合, 秀信
宮崎大学
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| ja-Kana |
オチアイ, ヒデノブ
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| en |
Ochiai, Hidenobu
University of Miyazaki
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Search repository
Yasunaga, Hideo
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| 抄録 |
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内容記述タイプ |
Abstract |
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内容記述 |
Background
In patients with pneumonia requiring mechanical ventilation, increased airway secretions are associated with prolonged mechanical ventilation, but the effect of mucoactive agents remains unclear. The present study aimed to investigate the association between early administration of mucoactive agents and in-hospital mortality in patients with pneumonia requiring mechanical ventilation.
Methods
We conducted a retrospective cohort study using the Japanese Diagnosis Procedure Combination database, a nationwide inpatient database. Adult patients were eligible if they had a primary diagnosis of pneumonia and required invasive mechanical ventilation within 2 days of admission, with ventilation continued for ≥ 2 days between April 2012 and March 2023. Patients were divided into those who received at least one mucoactive agent within 2 days after the initiation of mechanical ventilation (mucoactive agent group) and those who did not (control group). Mucoactive agents included ambroxol (oral), bromhexine (oral, intravenous and nebulized), fudosteine (oral), carbocisteine (oral) and N-acetylcysteine (nebulized). We performed a propensity score overlap weighting analysis to compare in-hospital mortality. The number of ventilator-free days at 28 days was assessed as a secondary outcome. We also performed sensitivity analyses using inverse probability of treatment weighting, generalized estimating equations, and doubly robust methods.
Results
Eligible patients (n = 10,942) were categorized into the mucoactive agent group (n = 2246) or control group (n = 8696). The most commonly prescribed mucoactive agent was carbocisteine (oral). After overlap weighting, in-hospital mortality was significantly lower in the mucoactive agent group than in the control group (25.2% vs. 27.5%; risk difference, − 2.3%; 95% confidence interval, − 4.4% to − 0.3%; p = 0.028). Ventilator-free days at 28 days did not significantly differ between the mucoactive agent group and the control group. Sensitivity analyses yielded similar results.
Conclusions
In patients with ventilated pneumonia, early administration of mucoactive agents was associated with lower in-hospital mortality. |
|
言語 |
en |
| 書誌情報 |
en : Journal of intensive care
巻 13,
p. 57,
発行日 2025-10-16
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| 出版者 |
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出版者 |
Springer Science and Business Media LLC |
|
言語 |
en |
| ISSN |
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収録物識別子タイプ |
PISSN |
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収録物識別子 |
20520492 |
| DOI |
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関連タイプ |
isVersionOf |
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識別子タイプ |
DOI |
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関連識別子 |
https://doi.org/10.1186/s40560-025-00826-7 |
| 著者版フラグ |
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出版タイプ |
VoR |
fulltext (1.3 MB)
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