1. Association of pre-hospital theophylline use and mortality in chronic obstructive pulmonary disease patients with sepsis
- Author
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Yen-Tao Hsu, Hsi Chu, Peter C. Hou, Shuo-Ming Ou, Ran-Chou Chen, Chia-Jen Shih, Raghu Seethala, Sadeq A. Quraishi, Yu-Ning Shih, Gyorgy Frendl, Yung Tai Chen, and Imoigele P. Aisiku
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Taiwan ,030204 cardiovascular system & hematology ,Lower risk ,law.invention ,Sepsis ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Theophylline ,Risk Factors ,law ,Internal medicine ,Outcome Assessment, Health Care ,medicine ,Humans ,Hospital Mortality ,Propensity Score ,Aged ,Aged, 80 and over ,Mechanical ventilation ,COPD ,business.industry ,Proportional hazards model ,Middle Aged ,medicine.disease ,Respiration, Artificial ,Intensive care unit ,Bronchodilator Agents ,Hospitalization ,Intensive Care Units ,030228 respiratory system ,Anesthesia ,Cohort ,Female ,business ,medicine.drug - Abstract
Background Although theophylline has been shown to have anti-inflammatory effects, the therapeutic use of theophylline before sepsis is unknown. The aim of our study was to determine the effect of theophylline on COPD patients presenting with sepsis. Methods This nationwide, population-based, propensity score-matched analysis used data from the linked administrative databases of Taiwan's National Health Insurance program. Patients with COPD who were hospitalized for sepsis between 2000 and 2011 were divided into theophylline users and non-users. The primary outcome was 30-day mortality. The secondary outcome was in-hospital death, intensive care unit admission, and need for mechanical ventilation. Cox proportional hazard model and conditional logistic regression were used to calculate the risk between groups. Results A propensity score-matched cohort of 51,801 theophylline users and 51,801 non-users was included. Compared with non-users, the 30-day (HR 0.931, 95% CI 0.910–0.953), 180-day (HR 0.930, 95% CI 0.914–0.946), 365-day (HR 0.944, 95% CI 0.929–0.960) and overall mortality (HR 0.965, 95% CI 0.952–0.979) were all significantly lower in theophylline users. Additionally, the theophylline users also had lower risk of in-hospital death (OR 0.895, 95% CI 0.873–0.918) and need for mechanical ventilation (OR 0.972, 95% CI 0.949–0.997). Conclusions Theophylline use is associated with a lower risk of sepsis-related mortality in COPD patients. Pre-hospital theophylline use may be protective to COPD patients with sepsis.
- Published
- 2017