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논문 기본 정보

자료유형
학술저널
저자정보
Lee Hannah (Department of Anesthesiology and Pain Medicine Seoul National University Hospital Seoul National Un) Choi Seongmi (Health Insurance Policy Research Institute National Health Insurance Service Wonju Korea.) Jang Eun Jin (Department of Information Statistics Andong National University Andong Korea.) Lee Juhee (Department of Statistics Kyungpook National University Daegu Korea.) Kim Dalho (Department of Statistics Kyungpook National University Daegu Korea.) Yoo Seokha (Department of Anesthesiology and Pain Medicine Seoul National University Hospital Seoul National Un) Oh Seung-Young (Department of Surgery Seoul National University Hospital Seoul National University College of Medic) Ryu Ho Geol (Department of Anesthesiology and Pain Medicine Seoul National University Hospital Seoul National Un)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.36 No.34
발행연도
2021.8
수록면
1 - 11 (11page)
DOI
10.3346/jkms.2021.36.e221

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Background: The purpose of this study was to assess the correlation between sedatives and mortality in critically ill patients who required mechanical ventilation (MV) for ≥ 48 hours from 2008 to 2016. Methods: We conducted a nationwide retrospective cohort study using population-based healthcare reimbursement claims database. Data from adult patients (aged ≥ 18) who underwent MV for ≥ 48 hours between 2008 and 2016 were identified and extracted from the National Health Insurance Service database. The benzodiazepine group consisted of patients who were administered benzodiazepines for sedation during MV. All other patients were assigned to the non-benzodiazepine group. Results: A total of 158,712 patients requiring MV for ≥ 48 hours were admitted in 55 centers in Korea from 2008 to 2016. The benzodiazepine group had significantly higher in-hospital and one-year mortality compared to the non-benzodiazepine group (37.0% vs. 34.3%, 55.0% vs. 54.4%, respectively). Benzodiazepine use decreased from 2008 to 2016, after adjusting for age, sex, and mean Elixhauser comorbidity index in the Poisson regression analysis (incidence rate ratio, 0.968; 95% confident interval, 0.954?0.983; P < 0.001). Benzodiazepine use, older age, lower case volume (≤ 500 cases/year), chronic kidney disease, and higher Elixhauser comorbidity index were common significant risk factors for in-hospital and oneyear mortality. Conclusion: In critically ill patients undergoing MV for ≥ 48 hour, the use of benzodiazepines for sedation, older age, and chronic kidney disease were associated with higher in-hospital mortality and one-year mortality. Further studies are needed to evaluate the impact of benzodiazepines on the mortality in elderly patients with chronic kidney disease requiring MV for ≥ 48 hours.
#Sedative #Dexmedetomidine #Mortality #Benzodiazepine #Propofol

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참고문헌 (36)

참고문헌 신청
Jacobi J / 2002 / Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult / Crit Care Med 30(1):119~141 google schola Payen JF / 2007 / Current practices in sedation and analgesia for mechanically ventilated critically ill patients : a prospective multicenter patient-based study / Anesthesiology 106(4):687~695 google schola Mehlhorn J / 2014 / Rehabilitation interventions for postintensive care syndrome : a systematic review / Crit Care Med 42(5):1263~1271 google schola Devlin JW / 2008 / The pharmacology of oversedation in mechanically ventilated adults / Curr Opin Crit Care 14(4):403~407 google schola Pandharipande PP / 2007 / Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients : the MENDS randomized controlled trial / JAMA 298(22):2644~2653 google schola

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