Association of ondansetron use with short-and long-term prognosis in patients with severe cerebrovascular disease:a retrospective cohort study based on the MIMIC-Ⅳ database
10.12173/j.issn.1005-0698.202502001
- VernacularTitle:昂丹司琼与重症脑血管疾病患者短期、长期预后的关联:基于MIMIC-Ⅳ数据库的回顾性队列研究
- Author:
Sisi QIN
1
;
Yuping ZHOU
;
Jijie XIAO
Author Information
1. 中山大学附属第五医院重症医学科(广东珠海 519000)
- Publication Type:Journal Article
- Keywords:
Ondansetron;
Severe cerebrovascular disease;
Prognosis;
MIMIC-Ⅳ database
- From:
Chinese Journal of Pharmacoepidemiology
2025;34(9):1017-1024
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the association of ondansetron use with short-term mortality risk and long-term mortality risk in patients with cerebrovascular disease.Methods Clinical data of patients with cerebrovascular disease admitted to the intensive care unit(ICU)between 2008 and 2022 from the MIMIC-Ⅳ database were retrospectively collected.All enrolled subjects were divided into an ondansetron group and a non-ondansetron group according to whether they had used ondansetron during their hospitalization.The differences in clinical indicators between the two groups were equalized using a 1∶1 propensity score matching(PSM)method.Kaplan-Meier survival analyses were employed to compare the differences in survival rates between the two groups at ICU,hospital,30-and 90-day,respectively.Cox proportional-hazards regression models were employed to analyze the associations between ondansetron use and ICU,hospital,and 30-and 90-day all-cause mortality in critically ill patients with cerebrovascular disease.Results The study included 9,198 patients with cerebrovascular disease,including 3,514 in the ondansetron group and 5,684 in the non-ondansetron group.Pre-matched baseline data showed that the overall ICU,hospital,and 30-and 90-day mortality rates in the ondansetron group were 7.0％,12.4％,15.9％,and 21.3％respectively,while those in the non-ondansetron group were 11.0％,17.2％,22.3％and 27.9％respectively.After 1∶1 PSM equalization of baseline data,a total of 3,239 pairs were successfully matched.Based on the matched data,Kaplan-Meier survival analyses showed higher survival rates of ICU(P＜0.001),hospital(P＜0.001),30 d(P＜0.001),and 90 d(P＜0.001)in the ondansetron group compared to the non-ondansetron group.In Cox proportional-hazards analysis,after adjustment for potential confounders,the hazard ratios(HR)in the ondansetron group relative to the non-ondansetron group were 0.60[95％CI(0.51,0.71),P＜0.001]for ICU mortality,0.73[95％CI(0.64,0.83),P＜0.001]for hospital mortality,0.76[95％CI(0.67,0.85),P＜0.001]for 30 d mortality,and 0.81[95％CI(0.73,0.89),P＜0.001]risk ratio for 90 d mortality.Conclusion The use of ondansetron may significantly decrease the ICU,hospital,30 d and 90 d risk of mortality in patients with severe cerebrovascular disease.
